Research effort may create ‘prototype’ to help cancer survivors manage cardiovascular risks
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An NCI grant will fund research designed to better coordinate care for cancer survivors with cardiovascular risks.
The 5-year, $4.83 million grant will support Advancing Care Coordination to Enhance Shared Care for Complex Survivors in Primary Care (ACCESS-PC), which aims to improve connections between patients with cancer and primary care physicians to strengthen survivorship care.
Denalee O’Malley, PhD, LSW — assistant professor and social work researcher in family medicine and community health at Rutgers Robert Wood Johnson Medical School and a research member of Rutgers Cancer Institute — will lead the research effort.
“We hope this will create a prototype for better care delivery and communication,” O’Malley told Healio.
Rutgers is one of four sites to receive funding this year as part of NCI’s initiative to address the primary care needs of cancer survivors.
Healio spoke with O’Malley about how her team’s research will unfold and the importance of addressing cardiovascular risk factors among the increasing number of cancer survivors in the United States.
Healio: Why is it important to improve coordination of cardiovascular disease risk management?
O’Malley: The aging process is almost accelerated among cancer survivors, so cardiovascular disease is more prevalent and can happen earlier. We need to work toward better management of these risks by improving care delivery processes and strategies. Cancer teams are designed to treat cancer, and cancer can be all-consuming initially. It’s a very stressful diagnosis; people want to focus on their cancer. We want to get the focus a bit broader as early as possible to help prevent and manage cardiovascular risk.
Healio: What are your plans for this research project?
O’Malley: We have proposed several implementation strategies at different levels — patient education, health system infrastructure, and cancer team and PCP outreach — to ensure everyone is on the same page to protocolize and standardize care planning communication. We know this can be complicated, as adult cancer survivors see a care team in one system — or perhaps across multiple systems — and their PCP may be outside that system.
The first year, we are going to be talking to people with different pockets of expertise. We want to see what would work, how short and specific we would need this information to be, how we can best send it between teams and what factors we need to keep in mind to improve patient care. The second, third and fourth years will be the implementation/clinical trial phase.
Healio: What will that phase entail?
O’ Malley: We will recruit and randomly assign 266 patients to receive usual care or the intervention, called Primary Care Connect. The goal is to provide information to cancer survivors about shared care beginning at cancer diagnosis, while aiming to standardize care planning communication protocols between teams. We want to know whether our patients stay more connected to their PCP if they receive Primary Care Connect, and whether their cardiovascular disease risk factors are managed better. We also want to know whether patients feel better equipped to manage their overall care — both their cancer and their chronic disease.
Healio: How can oncologists improve communication with primary care to help patients reduce cardiovascular risk?
O’Malley: They can encourage patients to remain connected to their PCP during treatment and beyond. In the first year of cancer treatment, patients tend to become disconnected from their PCP, but they eventually find their way back. Can we do things differently so they don’t lose connection in the first place? How can we do that? Can we leverage telehealth?
Healio: Is there anything else you’d like to mention?
O’Malley: The challenges of coordination are not unique to cancer and cardiovascular disease. Because active cancer treatment is such an intense care period, we prioritize the cancer care. We want to avoid having primary care fall off the radar, but also not overdo it. We want it to be something that’s easily actionable and manageable for patients, and not static. We don’t want to create a care plan; rather, this is more about a care process document that changes over time.
Reference:
- Rutgers Health. Researchers aim to transform cancer survivorship care in the U.S. by enhancing the adoption of shared delivery models (press release). Available at: https://www.rutgers.edu/news/rutgers-health-receives-48-million-federal-grant-fund-research-reduce-cardiovascular-risks. Published Aug. 14, 2024. Accessed Sept. 10, 2024.
For more information:
Denalee O’Malley, PhD, MSW, can be reached at omalledm@rutgers.edu.
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