Aims: Breast cancer and cardiovascular disease (CVD) share common risk factors, and breast cancer treatment substantially increases risk for CVD, yet little is known regarding preferred models of care. This study examined stakeholder views on management of CVD in breast cancer patients and survivors via a proposed nurse-led model of care.
Methods: Stakeholder consultations on management of CVD in breast cancer were held via telephone interviews and focus groups, professionally transcribed, then thematically analysed using an iterative coding process.
Results: Participants (N=33) included breast cancer consumers (N=7), oncologists (N=5) oncology nurses (N=2), breast care nurses (N=4), cardiologists (N=5), cardiac nurses (n=3), general practitioners (GPs) (N=4) and non-government organisation (NGO) representatives (N=3). Identified themes included a) unmet need to address CVD risk in patients and survivors; b) support for the proposed nurse-led model of care c) lack of awareness of CVD risks among breast cancer patients, survivors, and some health professionals; d) tension between need to raise awareness of CVD risks and information overload, heightened stress, patients' focus on cancer, inadequate patient-focused resources, and lack of clinician time to address risks; e) tension between need for patient self-management and socioeconomic and individual/psychological barriers; f) tension between need for GP involvement, underutilisation of GPs, GP time constraints, and patient access to quality relationships with GPs; g) need for effective coordination between health professionals to ensure best care in addressing CVD and h) need to integrate the proposed model of care with existing services in oncology and cardiac rehabilitation.
Conclusions: Management of CVD risk in breast cancer patients and survivors represents an important unmet need that can potentially be met using a nurse-led model of care. Such a model would require protocols for communication and education for patients, survivors and a multidisciplinary team of health professionals that is inclusive of GPs.