Communication Strategies for End-of-Life Cancer Care
((PATH-SIC) Trial)

Recruiting in Palo Alto (17 mi)

Overseen byChristopher Manz, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Dana-Farber Cancer Institute

No Placebo Group

Trial Summary

What is the purpose of this trial?The purpose of this study is to increase serious illness conversations (SICs) about patients goals and preferences regarding their healthcare between patients with cancer and their oncology clinicians and improved care provided near the end of life.

Eligibility Criteria

This trial is for adults with certain types of cancer (urogenital, breast, gastrointestinal, gynecologic, genitourinary, or lung) who have a poor prognosis and an upcoming appointment at specific Dana Farber Cancer Institute oncology clinics. Those already having serious illness conversations documented or previously enrolled in this trial are excluded.

Inclusion Criteria

I am 18 or older, have a poor prognosis, and have an appointment at a specified Dana Farber clinic.

Exclusion Criteria

Patients with an SIC documented in the Advance Care Planning module of the electronic health record in the 6 months prior to reaching a poor prognosis node

Patients who have previously been randomized in this trial (e.g., the patient is encountering a poor-prognosis node for the second time during the trial period)

Participant Groups

The PATH-SIC study tests whether sending nudge emails to clinicians and letters plus questionnaires to patients can increase meaningful discussions about healthcare goals and end-of-life care preferences between cancer patients and their doctors.

4Treatment groups

Experimental Treatment

Active Control

Group I: Patient receives a nudge but not the clinicianExperimental Treatment1 Intervention

-Patient nudge consists of a letter and SHARE questionnaire

Group II: Clinician receives a nudge but not the patientExperimental Treatment1 Intervention

-Clinician "nudge" email encouraging discussion to initiate discussion on SIC

Group III: Both patient and clinician receive a nudgeExperimental Treatment2 Interventions

* Patient nudge consists of a letter and SHARE questionnaire * Clinician "nudge" email encouraging discussion to initiate discussion on SIC

Group IV: Neither the patient nor clinician receive a nudgeActive Control1 Intervention

Standard Care