TY - JOUR
T1 - Cardiovascular Preventive Care and Coordination of Care in Prostate Cancer Survivors
T2 - A Multi-Institutional Prospective Study
AU - Holmes, Jordan A.
AU - Anderson, Roger F.
AU - Hoffman, Leroy G.
AU - Showalter, Timothy N.
AU - Kasibhatla, Mohit
AU - Collins, Sean P.
AU - Papagikos, Michael A.
AU - Barbosa, Brittany D.
AU - Alligood, Kristy
AU - Stravers, Lori J.
AU - Mahbooba, Zahra
AU - Wang, Andrew Z.
AU - Chen, Ronald C.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Purpose: Prostate cancer survivors who receive androgen deprivation therapy (ADT) are at increased risk of cardiovascular disease. They require coordinated care between cancer specialists and primary care physicians to monitor for cancer control and manage cardiovascular risk factors. Methods and Materials: We prospectively enrolled 103 men receiving ADT with radiation therapy (RT) from 7 institutions to assess cardiovascular risk factors and survivorship care. Medical records, fasting laboratory test values, and patient-reported outcomes using a validated instrument were assessed at baseline (pretreatment) and 1 year post-RT. Results: Cardiovascular disease (39%) and risk factors (diabetes, 22%; hypertension, 63%; hyperlipidemia, 31%) were prevalent at baseline. During the first year after RT completion, 63% received cardiovascular monitoring concordant with American Heart Association guidelines. Fasting laboratory test values at 1 year showed 24% with inadequately controlled blood sugar and 22% elevated cholesterol. Patient perceptions about care coordination were relatively low. At 1 year, 57% reported that their primary care physicians “always know about the care I receive at other places,” 67% reported that their cancer physician “communicated with other providers I see,” and 65% reported that the cancer care physician “knows the results of my visits with other doctors.” Conclusions: Patients with prostate cancer who receive ADT and RT are a vulnerable population with prevalent baseline cardiovascular disease and risk factors and suboptimal survivorship care specifically related to coordinated care and cardiovascular monitoring. Clinical trials examining ways to improve the care and outcomes of these survivors are needed.
AB - Purpose: Prostate cancer survivors who receive androgen deprivation therapy (ADT) are at increased risk of cardiovascular disease. They require coordinated care between cancer specialists and primary care physicians to monitor for cancer control and manage cardiovascular risk factors. Methods and Materials: We prospectively enrolled 103 men receiving ADT with radiation therapy (RT) from 7 institutions to assess cardiovascular risk factors and survivorship care. Medical records, fasting laboratory test values, and patient-reported outcomes using a validated instrument were assessed at baseline (pretreatment) and 1 year post-RT. Results: Cardiovascular disease (39%) and risk factors (diabetes, 22%; hypertension, 63%; hyperlipidemia, 31%) were prevalent at baseline. During the first year after RT completion, 63% received cardiovascular monitoring concordant with American Heart Association guidelines. Fasting laboratory test values at 1 year showed 24% with inadequately controlled blood sugar and 22% elevated cholesterol. Patient perceptions about care coordination were relatively low. At 1 year, 57% reported that their primary care physicians “always know about the care I receive at other places,” 67% reported that their cancer physician “communicated with other providers I see,” and 65% reported that the cancer care physician “knows the results of my visits with other doctors.” Conclusions: Patients with prostate cancer who receive ADT and RT are a vulnerable population with prevalent baseline cardiovascular disease and risk factors and suboptimal survivorship care specifically related to coordinated care and cardiovascular monitoring. Clinical trials examining ways to improve the care and outcomes of these survivors are needed.
UR - http://www.scopus.com/inward/record.url?scp=85055557369&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055557369&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2018.07.2018
DO - 10.1016/j.ijrobp.2018.07.2018
M3 - Article
C2 - 30099132
AN - SCOPUS:85055557369
SN - 0360-3016
VL - 103
SP - 112
EP - 115
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -