title: Increasing cardiomyopathy screening in at-risk adult survivors of pediatric malignancies: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether the addition of advanced-practice nurse (APN) telephone counseling to a printed survivorship care plan (SCP) significantly increases the proportion of at-risk survivors who complete cardiomyopathy screening.
  
  
  METHODS
  Survivors age ≥ 25 years participating in the Childhood Cancer Survivor Study who received cardiotoxic therapy and reported no history of cardiomyopathy screening in the previous 5 years were eligible for enrollment. The 472 participants (mean age, 40.1 years; range, 25.0 to 59.0; 53.3% women) were randomly assigned to either standard care, consisting of an SCP summarizing cancer treatment and cardiac health screening recommendations (n = 234), or standard care plus two APN telephone counseling sessions (n = 238). The primary outcome-completion of cardiomyopathy screening within 1 year-was validated by medical records and compared between the two arms using adjusted relative risks (RRs) with 95% CIs.
  
  
  RESULTS
  Participants in the standard and APN counseling groups were not statistically different by demographic or clinical characteristics. At the time of 1-year follow-up, 107 (52.2%) of 205 survivors in the APN group completed screening compared with 46 (22.3%) of 206 survivors in the non-APN group (P < .001). With adjustment for sex, age (< 30 v ≥ 30 years), and Children's Oncology Group-recommended screening frequency group (annual, 2 years, or 5 years), survivors in the APN group were > 2× more likely than those in the control group to complete the recommended cardiomyopathy screening (RR, 2.31; 95% CI, 1.74 to 3.07).
  
  
  CONCLUSIONS
  The addition of telephone counseling to an SCP with cardiac health screening recommendations increases cardiomyopathy screening in at-risk survivors.
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY. melissa.hudson@stjude.org.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Kayla K
authors.initials: KK
authors.lastname: Stratton
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Nina
authors.initials: N
authors.lastname: Tinner
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Brenda D
authors.initials: BD
authors.lastname: Steen
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Susan
authors.initials: S
authors.lastname: Ogg
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Linda
authors.initials: L
authors.lastname: Barnes
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Melissa M. Hudson, Nina Tinner, Brenda D. Steen, Susan Ogg, Linda Barnes, Leslie L. Robison, and Cheryl L. Cox, St Jude Children's Research Hospital, Memphis, TN; Wendy Leisenring and Kayla K. Stratton, Fred Hutchinson Cancer Research Center, Seattle, WA; and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Cox
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D012306:Risk; D015996:Survival Rate; D017741:Survivors; D017216:Telemedicine; D016896:Treatment Outcome