The state of cardio-oncology in oman: awareness, practices, and training needs among healthcare providers

Cancer therapy–related cardiovascular toxicity (CTR-CVT) is an increasingly recognized complication of modern cancer treatment. Despite international guidelines, cardio-oncology remains an evolving subspecialty, with limited data from the Middle East. This study aimed to assess awareness, clinical practices, service availability, and training needs in cardio-oncology among healthcare providers (HCPs) in Oman.

We conducted a national, cross-sectional survey of physicians and clinical pharmacists practicing in Oman between April and December 2025. A validated 45-item questionnaire, previously used in international studies, assessed demographics, awareness of cardio-oncology, service availability, clinical practices, education and training, and responses to two standardized cardiotoxicity-related clinical scenarios. Awareness was evaluated using both item-level responses across five core cardio-oncology domains and a composite awareness framework. Comparisons were made between cardiologists and oncologists and across healthcare settings.

A total of 124 respondents (74.3%) completed the survey, representing tertiary, regional, and local healthcare centers nationwide. Overall awareness of cardio-oncology was moderate to high, with strong recognition of diagnosis, management, and risk stratification of cardiotoxicity (>85%). However, awareness was lower for survivorship care (62%) and patient education (58%). Using the composite framework, 64% met minimum awareness criteria, while only 51% demonstrated comprehensive awareness. Access to dedicated cardio-oncology services was limited, with most care delivered through general cardiology consultations. Major barriers included limited funding (28%), inadequate infrastructure (25%), and variable institutional support (21%). Cardiologists reported significantly higher confidence and knowledge in managing cardiotoxicity than oncologists (p < 0.01). Tertiary centers demonstrated significantly higher awareness and guideline adherence compared with secondary and local centers (p < 0.001).

Healthcare providers in Oman demonstrate foundational knowledge of cardio-oncology; however, a substantial gap persists between awareness and clinical implementation. Limited service availability and structured training remain key barriers. Establishing dedicated multidisciplinary cardio-oncology programs and targeted educational initiatives is essential to improve guideline-based care and optimize cardiovascular outcomes for cancer patients.