Cardiotoxicity and cancer care: scoping review exploring current home-based, self-management cancer care interventions

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): NHS Lothian Background/Introduction Cardiotoxicity is heart damage that occurs as consequence of some cancer treatments and drugs. Gaining a better understanding of current cancer prehabilitation and rehabilitation programmes, specifically facilitated, home-based programmes, can better illuminate how interventions can aid patients in their cancer, and possible cardiac journey. This scoping review sets out to explore the provision of multimodal, cancer prehabilitation and rehabilitation programmes available to patients. Home-based, self-management, multidimensional cancer interventions (HSMCIs) are increasing in number, due to the growing population of people living with and beyond cancer. These multimodal programmes target a range of physical and psychosocial factors to improve self-management and quality of life amongst cancer patients during prehabilitation and rehabilitation. However, preliminary searches indicate that the interventions vary significantly in their definitions of key terms, target demographics, implementation success and evidence-base. Purpose This scoping review aims to assess the nature, extent and remit of existing HSMCIs, identify their strengths, limitations, potential barriers to access and obstacles to their implementation, and clarify key terms and concepts within the field. Methods Key word searches were performed in AMED, Cochrane, PsychInfo, Medline, CINAHL and Embase databases from 2010 to 2022 to identify papers relevant to HSMCIs. Study characteristics for inclusion were home-based, multimodal, non-centre based interventions that dealt with prehabilitaton and/or rehabilitation for cancer patients, while incorporating psychological, physical and nutritional components. Results The search gleaned a total of 302 results. These results were screened independently by two investigators with a third member conducting spot checks to ensure rigor. Early findings were then cross-referenced and irrelevant papers and duplicates were removed. A total of 38 results remained that fulfilled inclusion criteria. The scoping review found that few programmes were truly multimodal taking a general approach to cancer, instead targeted one or two specific cancers. Fewer still had mention of cardiotoxicity and how to manage heart health during cancer treatment. Conclusions This scoping review has highlighted the gap for a HSMCI in care provision to cover the range of biopsychosocial support needed for those living with and beyond cancer. Consistent with earlier research it emphasises the necessity for promoting cardiovascular health in this population.