ASPO Abstracts
Cardiovascular Health Assessment in the Oncology Setting: Perceptions and Knowledge of Cardiovascular Risk Factors among Breast Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose: Our team adapted an electronic health record cardiovascular health (CVH) data visualization
application, initially developed for primary care, for use in survivorship care. We evaluated the Automated
Heart-Health Application (AH-HA) and assessed change in breast cancer survivors’ knowledge of CVH pre-
and post-use of the tool and concordance of self-reported and EHR-reported CVH risk factors.
Methods: Post-treatment breast cancer survivors (n=49) completed a survey pre- and post-use of AH-HA to
assess CVH perceptions, defined as: 1) confidence in understanding risk of heart disease, 2) understanding
steps needed to improve CVH, and 3) perception that heart disease poses a risk to health. Items were
assessed on a 5-point Likert scale from strongly disagree (1) to strongly agree (5). The pre-survey also
assessed knowledge of four CVH factors [weight/height for body mass index (BMI), blood pressure, total
cholesterol, and hemoglobin A1c/fasting glucose]. Survivors reported factors as “high” (poor), “somewhat high”
(intermediate), or “normal” (ideal). Self-reported values were compared to EHR-abstracted values to calculate
percent agreement, in accordance with American Heart Association Simple 7 Guidelines.
Results: Enrolled survivors (84% White, 8% Black; 4% Hispanic) were on average 64 years old and 11 years
post-diagnosis. Ninety-two percent had early-stage cancers. Prior to viewing the tool, 24% of survivors
expressed strong agreement that they understood their risk of CV disease; 58% agreed. Yet, 65% reported not
knowing the level for one or more CVH factors. On average, only 45% of survivors’ known factors were at an
ideal level. Less than half of survivors had BMI (24%), blood pressure (24%), and cholesterol (49%) in the ideal
category. Concordance of self-reported with EHR categorization of CVH factors was 90% for BMI, 47% for
blood pressure, 41% for cholesterol, and 33% for blood glucose. Significant positive changes after viewing the
AH-HA tool were observed for understanding of CV risk (S=-65, p=0.009), understanding steps to improve
CVH (S=-70.5, p<.001, and perception of CV risk (S=-45, p=0.007).
Conclusions: Integration of CVH assessment tools in oncology care may enhance awareness and
understanding of CVH among breast cancer survivors.
Keywords: Electronic Health Records, Cardiovascular Diseases, Breast Cancer, Survivorship