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Improving paediatric cardiologists’ awareness about the needs of childhood cancer survivors: results of a single-centre directed educational initiative

Published online by Cambridge University Press:  12 June 2019

Kirsten Rose-Felker
Affiliation:
Sibley Heart Center Cardiology, Emory University, Atlanta, GA, USA Department of Pediatrics, Emory University, Atlanta, GA, USA
Karen Effinger
Affiliation:
Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, USA Department of Pediatrics, Emory University, Atlanta, GA, USA
Michael S Kelleman
Affiliation:
Children’s Healthcare of Atlanta, Emory University, Atlanta, GA, USA
Ritu Sachdeva
Affiliation:
Sibley Heart Center Cardiology, Emory University, Atlanta, GA, USA Department of Pediatrics, Emory University, Atlanta, GA, USA
Lillian R. Meacham
Affiliation:
Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, USA Department of Pediatrics, Emory University, Atlanta, GA, USA
William L. Border*
Affiliation:
Sibley Heart Center Cardiology, Emory University, Atlanta, GA, USA Department of Pediatrics, Emory University, Atlanta, GA, USA
*
Author for correspondence: William L Border, MD, Department of Pediatrics, Sibley Heart Center Cardiology, Emory University, 1405 Clifton Rd NE, Atlanta, GA 30322, USA. Tel: (404)256-2593; E-mail: borderw@kidsheart.com

Abstract

Background:

Cardiovascular disease is a leading cause of morbidity and mortality in childhood cancer survivors. Cardiologists must be aware of risk factors and long-term follow-up guidelines, which have historically been the purview of oncologists. Little is known about paediatric cardiologists’ knowledge regarding the cardiotoxicity of cancer treatment and how to improve this knowledge.

Methods:

A total of 58 paediatric cardiologists anonymously completed a 21-question, web-based survey focused on four cardio-oncology themes: cancer treatment-related risk factors (n = 6), patient-related risk factors (n = 6), recommended surveillance (n = 3), and cardiac-specific considerations (n = 6). Following the baseline survey, a multi-disciplinary team of paediatric cardiologists and cancer survivor providers developed an in-person and web-based educational intervention. A post-intervention survey was conducted 5 months later.

Results:

The response rate was 41/58 (70.7%) pre-intervention and 30/58 (51.7%) post-intervention. On the baseline survey, the percentage of correct answers was 68.8 ± 10.3%, which improved to 79.2 ± 16.2% after the intervention (p = 0.009). The theme with the most profound knowledge deficit was surveillance; however, it also had the greatest improvement after the intervention (49.6 ± 26.7 versus 66.7 ± 27.7% correct, p = 0.025). Individual questions with the largest per cent improvement pertained to risk of cardiac dysfunction with time since treatment (52.4 versus 93.1%, p = 0.002) and the role of dexrazoxane (48.8 versus 82.8%, p = 0.020).

Conclusion:

Specific knowledge deficits about the care of paediatric cancer survivors were identified amongst cardiologists using a web-based survey. Knowledge of surveillance was initially lowest but improved the most after an educational intervention. This highlights the need for cardio-oncology-based educational initiatives among paediatric cardiologists.

Type
Original Article
Copyright
© Cambridge University Press 2019 

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