EXPERIENCES IN DEVELOPING A CARDIO-ONCOLOGY CLINIC: A LITERATURE REVIEW

Abstract

Therapeutic Area: Preventive Cardiology Best Practices Background: Many chemotherapy agents utilized for cancer treatment can significantly impact a patient's cardiovascular health. Early intervention via cardio-oncology care can help minimize or prevent cardiovascular complications related to these treatments. Clinicians recognize the need for cardio-oncology services for their patients, however they additionally acknowledge certain barriers, including funding, and limited interest and infrastructure. This literature review aims to examine the experiences implementing a cardio-oncology clinic, characterize factors that led to their successes, and determine barriers during their implementation to guide future endeavors. Methods: The PubMed search engine was used for a literature review and restricted to papers published between January 2000 and January 2023. The following search terms were used: “cardiooncology”, “cardio-oncology”, “program development”, “program”, “institution”, and “clinic”. Inclusion criteria included primary literature, a focus on program/clinic development, and the study was written in English. Results: Search results yielded 770 studies with authors SK and AA reviewing their abstracts. Twenty-four unique preliminarily met the inclusion criteria though after full article review, only 7 of the 24 studies met all criteria.From the seven studies that were reviewed, themes related to success and barriers when establishing a cardio-oncology program were identified. Themes related to success included: staff education, departmental cooperation, institutional support, utilizing pre-existing resources, developing program-specific referral algorithms, and community outreach. Barriers related to establishing a program included: unexpected rapid growth and lack of clinical standards to guide practice. The two most common themes for success amongst the articles were the importance of institutional support and departmental cooperation between oncology and cardiology. Likewise, the most common barrier was a lack of standardized clinical guidelines. Conclusions: Cardio-oncology clinics are recognized as useful entities but their establishment is often met with challenges and their execution is not consistent. In examining the experiences of implementing cardio-oncology clinics, certain themes for success are recurrent. These include departmental cooperation, institutional support, and community outreach. Lack of standard guidelines of practice, however, made implementation difficult. The development of cardio-oncology clinics can contribute to preventing cardiovascular diseases in patients with cancer, but strategies to develop these clinics appears to need further refinement and uniformity.