Carole Bouleuc1, Alexia Savignoni2, Marion Chevrier2, Evelyne Renault-Tessier3, Alexis Burnod3, Gisele Chvetzoff4, Phillipe Poulain5, Laure Copel6, Paul Cottu7, Jean-Yves Pierga7, Anne Brédart8, Sylvie Dolbeault9. 1. Supportive Care Department, Institut Curie, Palliative Care Unit, Paris, France; PSL, Paris Sciences Lettre, University Paris, Paris, France. Electronic address: carole.bouleuc@curie.net. 2. Clinical Research Department, Institut Curie, Biometric Unit, Paris, France; PSL, Paris Sciences Lettre, University Paris, Paris, France. 3. Supportive Care Department, Institut Curie, Palliative Care Unit, Paris, France; PSL, Paris Sciences Lettre, University Paris, Paris, France. 4. Palliative Care Department, Centre Léon Bérard, Lyon, France. 5. Palliative Care Department, Polyclinique de l'Ormeau, Tarbes, France. 6. Palliative Care Department, Diaconesses Croix Saint Simon Hospital, Paris, France. 7. Medical Oncology Department, Institut Curie, Paris, France; PSL, Paris Sciences Lettre, University Paris, Paris, France. 8. Institut Curie, Psycho-Oncology Unit, Paris, France; Institute of Psychology, Paris Descartes University, Boulogne-Billancourt, France. 9. Institut Curie, Psycho-Oncology Unit, Paris, France; CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, Villejuif, France.
Abstract
CONTEXT: Advance care planning is essential to enable informed medical decisions to be made and to reduce aggressiveness in end-of-life (EOL) care. OBJECTIVES: This study aimed to explore whether a question prompt list (QPL) adapted to French language and culture could promote discussions, particularly on prognosis and EOL issues, among advanced cancer patients attending outpatient palliative care (PC) consultations. METHODS: In this multicenter randomized study, patients assigned to the intervention arm received a QPL to help them prepare for the next consultation one month later. The main inclusion criteria were advanced cancer patients referred to the PC team with an estimated life expectancy of less than one year. The primary endpoint was the number of questions raised, globally and by topic. The secondary objectives were the impact of the QPL on psychological symptoms, quality of life, satisfaction with care, and coping styles at two months. RESULTS: Patients (n = 71) in the QPL arm asked more questions (mean 21.8 vs. 18.2, P = 0.03) than patients in the control arm (n = 71), particularly on PC (5.6 vs. 3.7, P = 0.012) and EOL issues (2.2 vs. 1, P = 0.018) but not on prognosis (4.3 vs. 3.6, not specified). At two months, there was no change in anxiety, depression, or quality of life in either arm; patient satisfaction with doctors' technical skills was scored higher (P = 0.024), and avoidance coping responses were less frequent (self-distraction, P = 0.015; behavioral disengagement, P = 0.025) in the QPL arm. CONCLUSION: Questions on PC and EOL issues in outpatient PC consultations were more frequent, and patient satisfaction was better when a QPL was made available before the consultation.
RCT Entities:
CONTEXT: Advance care planning is essential to enable informed medical decisions to be made and to reduce aggressiveness in end-of-life (EOL) care. OBJECTIVES: This study aimed to explore whether a question prompt list (QPL) adapted to French language and culture could promote discussions, particularly on prognosis and EOL issues, among advanced cancerpatients attending outpatient palliative care (PC) consultations. METHODS: In this multicenter randomized study, patients assigned to the intervention arm received a QPL to help them prepare for the next consultation one month later. The main inclusion criteria were advanced cancerpatients referred to the PC team with an estimated life expectancy of less than one year. The primary endpoint was the number of questions raised, globally and by topic. The secondary objectives were the impact of the QPL on psychological symptoms, quality of life, satisfaction with care, and coping styles at two months. RESULTS:Patients (n = 71) in the QPL arm asked more questions (mean 21.8 vs. 18.2, P = 0.03) than patients in the control arm (n = 71), particularly on PC (5.6 vs. 3.7, P = 0.012) and EOL issues (2.2 vs. 1, P = 0.018) but not on prognosis (4.3 vs. 3.6, not specified). At two months, there was no change in anxiety, depression, or quality of life in either arm; patient satisfaction with doctors' technical skills was scored higher (P = 0.024), and avoidance coping responses were less frequent (self-distraction, P = 0.015; behavioral disengagement, P = 0.025) in the QPL arm. CONCLUSION: Questions on PC and EOL issues in outpatient PC consultations were more frequent, and patient satisfaction was better when a QPL was made available before the consultation.
Authors: Rebecca E Ryan; Michael Connolly; Natalie K Bradford; Simon Henderson; Anthony Herbert; Lina Schonfeld; Jeanine Young; Josephine I Bothroyd; Amanda Henderson Journal: Cochrane Database Syst Rev Date: 2022-07-08
Authors: Lisa Hjelmfors; Jan Mårtensson; Anna Strömberg; Anna Sandgren; Maria Friedrichsen; Tiny Jaarsma Journal: Int J Environ Res Public Health Date: 2022-04-15 Impact factor: 4.614
Authors: Jiayi Du; Ling Fu; Jiaxin Cui; Zifen An; Pei Fang; Lanhui Tan; Xianmei Meng; Liping Yu Journal: Int J Environ Res Public Health Date: 2022-05-17 Impact factor: 4.614
Authors: Anne Brédart; Aude Rault; Johanna Terrasson; Etienne Seigneur; Leanne De Koning; Elisabeth Hess; Alexia Savignoni; Paul Cottu; Jean-Yves Pierga; Sophie Piperno-Neumann; Manuel Rodrigues; Carole Bouleuc; Sylvie Dolbeault Journal: JMIR Res Protoc Date: 2022-01-12