Follow-Up Phone Calls are Effective in Increasing Compliance with Screening for De Novo Cancer among Heart Transplant Recipients

PURPOSE We aimed to examine the effectiveness of serial follow-up phone calls as an intervention after clinic visits to enhance compliance with cancer surveillance among heart transplant (HT) patients. METHODS 41 HT cancer-free patients were randomized to intervention (n=21) vs. control (n=20) groups. Time Series Design was used; the intervention group received 4 calls post clinic visits within 31 days at different point intervals between 7-10 days, addressing the patient's specific needs for cancer screening based on immunotherapy and medical issues. The control group received 1 phone call at the end of the study. Chi-Square Statistics was used to compare screening rates between intervention and control groups. RESULTS Mean age was 60.3 years, 78% male, and 24% had prior malignancy. 39% of patients were studied 1-5 years post HT, 20% 5-10 years; 26% 10-14 years; and 15% 15-20 years. Main reasons for non-compliance reported by patients were: "too busy", "family issues", and "I forgot". At the end of the study, 50% of patients were fully compliant with cancer screening recommendations in the intervention group vs. 15% in the control group. This difference was statistically significant: (X2 (1)= 4.062, p= 0.044) (Fig. 1a). Compliance rates after each phone call are shown in Fig. 1b. CONCLUSION A nurse practitioner-led follow-up phone calls program is a feasible and effective strategy to increase compliance with de novo cancer screening among adult heart transplant recipients. Additional studies are needed to validate the usefulness of this approach in this unique patient population.