Increasing Cardiomyopathy Screening in Childhood Cancer Survivors: A Cost Analysis of Advanced Practice Nurse Phone Counseling

Oncol Nurs Forum. 2016 Nov 1;43(6):E242-E250. doi: 10.1188/16.ONF.E242-E250.


Purpose/objectives: To document the per survivor and per additional survivor screening costs of a mailed survivorship care plan (SCP) with advanced practice nurse (APN) telephone counseling (SCP+C) or without APN telephone counseling (SCP). .

Design: Randomized, longitudinal clinical trial. .

Setting: St. Jude Children's Research Hospital in Memphis, Tennessee. .

Sample: 411 at-risk pediatric cancer survivors (aged 26-59 years), stratified by age (younger than 30 years versus 30 years or older), recommended screening frequency (every one, two, or five years), gender, and cancer diagnosis (hematologic versus solid tumor). .

Methods: Clinical and resource data costs were derived from trial data and external estimates. .

Main research variables: The cost-effectiveness of left ventricular systolic function screening per survivor and per each additional survivor screened. .

Findings: The per-survivor costs of SCP (n = 206) and SCP+C (n = 205) were $74.91 and $224.69, respectively. The estimated costs of SCP and SCP+C per additional survivor screened for two years disseminated in a medium-sized clinic (n = 101 survivors annually) were $345.41 and $293.85, respectively. .

Conclusions: Adding APN counseling to a printed SCP may help preserve cardiac health at little or no cost per additional survivor screened. .

Implications for nursing: APN counseling is cost-effective and superior to the standard of care in supporting at-risk survivors' cardiac screening participation.

Keywords: Screening; cardiomyopathy; echocardiogram; nursing intervention; pediatric cancer; survivors.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advanced Practice Nursing / economics*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiomyopathies / diagnosis*
  • Cost-Benefit Analysis*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mass Screening / economics*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Surveys and Questionnaires
  • Survivors / statistics & numerical data*
  • Telemedicine / economics*
  • Telemedicine / statistics & numerical data
  • Tennessee