JMIR Publications

ABSTRACT

Background:

Cardiovascular health (CVH) is of increasing concern to breast cancer survivors and their healthcare providers. Adapting clinical decision support tools to address cardiovascular (CV) risk in the oncology setting may enhance survivors’ CVH management.

Objective:

We sought to examine the usability of a novel electronic health record (EHR) enabled CVH tool from the perspective of both breast cancer survivors and oncology providers who provide survivorship care.

Methods:

Breast cancer survivors (n=49) recruited from a survivorship clinic interacted with a patient-facing version of the CVH tool and completed pre- and post-tool assessments about CVH knowledge and perceptions of a patient-facing CVH assessment tool. Oncologists, physician assistants, and nurse practitioners (n=20) who provide care to survivors viewed the clinical decision support CVH tool and completed assessments of perceived usability and acceptability.

Results:

Enrolled breast cancer survivors (84% White, 4% Hispanic) predominately had stage 0/I/II disease (92%) and were on average 11 years post-diagnosis. Prior to viewing the tool, 65% of survivors (32 of 49) reported not knowing the level for one or more CVH factors (range of factors unknown: 0-4). On average, only 45% (range= 0-86) of survivors’ known CVH factors were at an ideal level. More than 50% of survivors had smoking status (45 of 48) and blood glucose values (29 of 45) in the ideal category; less than 50% had blood pressure (12 of 49), BMI (12 of 49), cholesterol (17 of 35), diet (7 of 49), and physical activity (10 of 49) in the ideal range. More than 90% of survivors thought the tool was easy to understand (46 of 47), improved their understanding (43 of 47), and was helpful (45 of 47); 94% (44 of 47 survivors) liked the tool. A majority of survivors (94%, 44 of 47) thought oncologists should discuss heart health during survivorship care. Sixty percent (12 of 20) of oncology providers (60% female, 12 of 20; 70% physicians, 14 of 20) had been practicing for more than 5 years. Most providers (>=75%) agreed the tool provided useful information, would help their effectiveness, was easy to use, and presented information in a useful format. Eighty-five percent of providers reported they would use the tool most or all of the time when providing survivorship care.

Conclusions:

These usability data demonstrate acceptability of a CVH assessment and clinical decision support tool in oncology practices. Oncology providers and breast cancer survivors would likely value the integration of such applications in survivorship care. By increasing awareness and communication regarding CVH, EHR-enabled tools may improve survivorship care delivery for breast cancer and ultimately patient outcomes. Clinical Trial: N/A