Guidelines specific to cancer patients needed
More education about assessment and management of cardiotoxicity would strengthen the quality of nursing care of cancer patients, according to a study presented at the Oncology Nursing Society’s 2010 Advanced Practice Nursing /Institutes of Learning (APN/IOL)Conference in Orlando, Florida.
The study by Wendy Vogel, MSN, FNP, AOCONP, of Kingsport Hematology Oncology Associates, Kingsport, Tennessee, and Marilyn Haas, PhD, ANP-BC, CNS, of CarePartners, Asheville, North Carolina, showed a gap in knowledge among oncology nurses, including advanced practice nurses (APNs), treating women with breast cancer. “This is a wide-open field for oncology nursing research,” said Vogel, who presented the findings.
To evaluate oncology nurses’ knowledge and practice patterns regarding cardiotoxicity in women with early-stage breast cancer treated with human epidermal growth factor receptor 2 inhibitors/vascular endothelial growth factor inhibitors, the researchers developed a 24-item survey. Surveys were distributed before and after the 2009 APN/IOL conference. Of the 248 nurses who responded to the survey, 88% of respondents worked in medical oncology settings; 26% identified themselves as APNs, 49% as staff nurses, and 25% other. Fifty-eight percent worked in the community outpatient setting, and 56% reported spending at least 1 to 2 hours per week educating breast cancer patients about cardiotoxicity.
Only 12% of the survey respondents said they felt very comfortable about assessing cardiotoxicity, and 25% reported feeling less than comfortable. More than 10% of respondents were uncertain which breast cancer drugs can cause cardiotoxicity, and more than 20% were unsure whether chemotherapeutic agents were discontinued or dose reduced because of cardiotoxicity in their practice.
Respondents reported that their primary resource used for managing breast cancer was textbooks (34%) followed by pharmaceutical representatives (18%), national guidelines (18%), and the Internet (17%). This was concerning Vogel said because textbooks do not provide the most up-to-date information, and guidelines prepared by the American Heart Association and American College of Cardiology are not specific for cancer patients.
Evidence-based guidelines on assessment and management of cardiotoxicity in patients with cancer are needed, Vogel said. This is becoming increasingly important, she explained because “we’re seeing patients age with cancer.” Better communication is needed between oncologists and cardiologists, she added, and “that’s where oncology nurses can make a difference—coordination of care.”
