Natasha Michael1,2,3, Clare O'Callaghan4,5, Ekavi Georgousopoulou6, Adelaide Melia4, Merlina Sulistio4,6,7, David Kissane4,6,7. 1. Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, VIC, Australia. nmichael@cabrini.com.au. 2. School of Medicine, Sydney Campus, University of Notre Dame Australia Darlinghurst, Darlinghurst, NSW, Australia. nmichael@cabrini.com.au. 3. Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. nmichael@cabrini.com.au. 4. Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, VIC, Australia. 5. Departments of Psychosocial Cancer Care, St Vincent's Hospital, Sydney, NSW, Australia. 6. School of Medicine, Sydney Campus, University of Notre Dame Australia Darlinghurst, Darlinghurst, NSW, Australia. 7. Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Abstract
BACKGROUND: Views on advance care planning (ACP) has shifted from a focus solely on treatment decisions at the end-of-life and medically orientated advanced directives to encouraging conversations on personal values and life goals, patient-caregiver communication and decision making, and family preparation. This study will evaluate the potential utility of a video decision support tool (VDST) that models values-based ACP discussions between cancer patients and their nominated caregivers to enable patients and families to achieve shared-decisions when completing ACP's. METHODS: This open-label, parallel-arm, phase II randomised control trial will recruit cancer patient-caregiver dyads across a large health network. Previously used written vignettes will be converted to video vignettes using the recommended methodology. Participants will be ≥18 years and be able to complete questionnaires. Dyads will be randomised in a 1:1 ratio to a usual care (UC) or VDST group. The VDST group will watch a video of several patient-caregiver dyads communicating personal values across different cancer trajectory stages and will receive verbal and written ACP information. The UC group will receive verbal and written ACP information. Patient and caregiver data will be collected individually via an anonymous questionnaire developed for the study, pre and post the UC and VDST intervention. Our primary outcome will be ACP completion rates. Secondarily, we will compare patient-caregiver (i) attitudes towards ACP, (ii) congruence in communication, and (iii) preparation for decision-making. CONCLUSION: We need to continue to explore innovative ways to engage cancer patients in ACP. This study will be the first VDST study to attempt to integrate values-based conversations into an ACP intervention. This pilot study's findings will assist with further refinement of the VDST and planning for a future multisite study. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry No: ACTRN12620001035910 . Registered 12 October 2020. Retrospectively registered.
RCT Entities:
BACKGROUND: Views on advance care planning (ACP) has shifted from a focus solely on treatment decisions at the end-of-life and medically orientated advanced directives to encouraging conversations on personal values and life goals, patient-caregiver communication and decision making, and family preparation. This study will evaluate the potential utility of a video decision support tool (VDST) that models values-based ACP discussions between cancerpatients and their nominated caregivers to enable patients and families to achieve shared-decisions when completing ACP's. METHODS: This open-label, parallel-arm, phase II randomised control trial will recruit cancerpatient-caregiver dyads across a large health network. Previously used written vignettes will be converted to video vignettes using the recommended methodology. Participants will be ≥18 years and be able to complete questionnaires. Dyads will be randomised in a 1:1 ratio to a usual care (UC) or VDST group. The VDST group will watch a video of several patient-caregiver dyads communicating personal values across different cancer trajectory stages and will receive verbal and written ACP information. The UC group will receive verbal and written ACP information. Patient and caregiver data will be collected individually via an anonymous questionnaire developed for the study, pre and post the UC and VDST intervention. Our primary outcome will be ACP completion rates. Secondarily, we will compare patient-caregiver (i) attitudes towards ACP, (ii) congruence in communication, and (iii) preparation for decision-making. CONCLUSION: We need to continue to explore innovative ways to engage cancerpatients in ACP. This study will be the first VDST study to attempt to integrate values-based conversations into an ACP intervention. This pilot study's findings will assist with further refinement of the VDST and planning for a future multisite study. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry No: ACTRN12620001035910 . Registered 12 October 2020. Retrospectively registered.
Entities:
Keywords:
Advance care planning; Cancer; Communication; Complex intervention; Decision aid; End-of-life care
Authors: Judith A C Rietjens; Rebecca L Sudore; Michael Connolly; Johannes J van Delden; Margaret A Drickamer; Mirjam Droger; Agnes van der Heide; Daren K Heyland; Dirk Houttekier; Daisy J A Janssen; Luciano Orsi; Sheila Payne; Jane Seymour; Ralf J Jox; Ida J Korfage Journal: Lancet Oncol Date: 2017-09 Impact factor: 41.316
Authors: Kelly A Barnes; Cate A Barlow; Jane Harrington; Karon Ornadel; Adrian Tookman; Michael King; Louise Jones Journal: Palliat Support Care Date: 2011-03
Authors: Natasha Michael; Clare O'Callaghan; Josephine Clayton; Annabel Pollard; Nikola Stepanov; Odette Spruyt; Michael Michael; David Ball Journal: Support Care Cancer Date: 2013-03-14 Impact factor: 3.603
Authors: Lindsay A Dow; Robin K Matsuyama; V Ramakrishnan; Laura Kuhn; Elizabeth B Lamont; Laurel Lyckholm; Thomas J Smith Journal: J Clin Oncol Date: 2009-11-23 Impact factor: 44.544
Authors: Ashu Jain; Sophie Corriveau; Kathleen Quinn; Amanda Gardhouse; Daniel Brandt Vegas; John J You Journal: BMJ Open Date: 2015-06-24 Impact factor: 2.692
Authors: Nienke Fleuren; Marja F I A Depla; Daisy J A Janssen; Martijn Huisman; Cees M P M Hertogh Journal: BMC Palliat Care Date: 2020-03-06 Impact factor: 3.234
Authors: Natasha Michael; Alex Gorelik; Ekavi Georgousopoulou; Merlina Sulistio; Patrick Tee; Katherine Hauser; David Kissane Journal: Support Care Cancer Date: 2022-05-25 Impact factor: 3.359