ArticleJournal of cancer survivorship : research and practice2021
Healthcare fragmentation and cardiovascular risk control among older cancer survivors in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study.
Article in Journal of cancer survivorship : research and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Barriers for access and utilization of dementia care services in Europe: a systematic review.BMC geriatrics · 2025Pooled it
- The needs and unmet needs for people living with dementia, caregivers and care workers in dementia health care systems: a systematic review.Frontiers in public health · 2025Pooled it
- Fragmented care and chronic illness patient outcomes: A systematic review.Nursing open · 2023Pooled it
- Diet and Prevention of Cardiovascular Disease and Cancer: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2025Review
- Article
- Predict Health Care Accessibility for Texas Medicaid Gap.Healthcare (Basel, Switzerland) · 2021Article
- Thirty-Day Post-Discharge Outcomes Following COVID-19 Infection.Journal of general internal medicine · 2021Article
- Fragmentation of Care Among Black Women With Breast Cancer and Comorbidities: The Role of Health Systems.JCO oncology practice · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
purposeCardiovascular disease (CVD) is the number one cause of death among 5-year cancer survivors. Survivors see many providers and poor coordination may contribute to worse CVD risk factor control. We sought to determine associations between fragmentation and CVD risk factor control among survivors overall and by self-rated health.
methodsWe included REGARDS participants aged 66+ years who (1) had a cancer history; (2) reported diabetes, hypertension, or hyperlipidemia; and (3) had continuous Medicare coverage. Twelve-month ambulatory care fragmentation was calculated using the Bice-Boxerman Index (BBI). We determined associations between fragmentation and CVD risk factors, defining "control" as fasting glucose < 126 mg/dL or non-fasting glucose < 200 mg/dL for diabetes; blood pressure < 140/90 mmHg for hypertension; and total cholesterol <240 mg/dL, low-density lipoprotein cholesterol < 160 mg/dL, or high-density lipoprotein cholesterol >40 mg/dL for hyperlipidemia.
resultsThe 1002 cancer survivors (2+ years since cancer treatment) had mean age of 75 years, 39% were women, and 23% were Black. Among individuals with diabetes (N = 225), hypertension (N = 660), and hyperlipidemia (N = 516), separately, approximately 60% had CVD risk factor control. Overall, more fragmented care was not associated with worse control. However, among cancer survivors with excellent, very good, or good health, more fragmentation was associated with a decreased likelihood of diabetes control (OR 0.78, 95% CI 0.61-0.99), adjusting for confounders.
conclusionsMore fragmented care was associated with worse glycemic control among cancer survivors with diabetes who reported excellent, very good, or good health. Associations were not observed for control of hypertension or hyperlipidemia. IMPLICATIONS FOR CANCER SURVIVORS: Reducing fragmentation may support glucose control among survivors with diabetes.
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