Neoplasms

Blood and Lymph Conditions

All Conditions

Hematologic Neoplasms

Hematologic Diseases

Patients will participate in an inpatient advance care planning intervention.

Inpatient advance care planning intervention that will be delivered by advanced care practitioners or hematology/oncology fellow physicians. The intervention will be an adapted version of the serious illness care program.

Inpatient serious illness care program

Kah Poh Loh

Marissa LoCastro

This is a pilot study to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies

Older adults with hematologic malignancies receive more aggressive inpatient care at the end of life compared to patients with solid tumors. Advance care planning may promote early serious illness conversations for patients with hematologic malignancies, leading to less aggressive healthcare utilization at the end of life. This pilot aims to assess the preliminary efficacy of an inpatient advance care planning intervention on outcomes in older patients with hematologic malignancies.

The intervention used in this study is an inpatient advance care planning intervention. We will adapt the Serious Illness Care Program, an evidence-based intervention that promotes serious illness conversation between patients and clinicians, to be used by advance practice providers and hematology/oncology fellow physicians in the inpatient setting.

An Inpatient Advance Care Planning Intervention for Older Patients With Hematologic Malignancies

A final study protocol including a description of the study participants, measurements, data, and analyses will be made publicly available before the publication date of the study findings. This will be available through the University of Rochester Cancer Center Community Oncology Research Program Research Base Protocol and Data Sharing Committee. The database will be de-identified prior to becoming publicly available. Published manuscripts will be available in portable document format.

Data on completion of advance directives will be collected via the electronic medical record. This will include explicit statement of the patient's medical preferences for end of life care in a note, scanned medical order for life sustaining treatment (MOLST) form that was completed with their clinician, and/or scanned healthcare proxy form that was completed with their clinician. This will be expressed as a percentage.

End of life quality indicators will be extracted from the electronic medical record. These metrics will include hospice enrollment, palliative care referral, chemotherapy administration within the last 2 weeks of life, emergency department visits in the last 30 days of life, intensive care unit admissions in the last 30 days of life, hospitalizations in the last 30 days of life, use of life-sustaining treatments in the last 30 days of life, transfusions in the last 7 days of life, and place of death. These will be expressed as percentages.

University of Rochester

Assistant Professor

Patients from experimental arm will benefit from a Standardized Advance Care Planning interview alone or in the presence of relatives within 3 days after randomization.

Patients from control arm will be treated without specific intervention, which does not exclude the possibility of resorting to non standardized advance care planning interviews with an oncologist or a physician specialized in palliative care.

Standardized interview based on The letter Project (Stanford Medicine) and Questions Prompt List

Advance Care Planning Intervention

Claire VIT

Manon VOEGELIN

Philippe TRENSZ, MD

Advanced Cancer patients hospitalized in a Cancer center inpatient unit have a dismal prognosis. Palliative Care interventions have shown multiple benefit for those patients, regarding quality of life, symptom management, illness understanding and aggressiveness of care criteria. Although Advance Care planning (ACP) is part of usual Palliative Care, specific interventions dedicated to ACP are understudied.

This study aims at showing that a simple and systematic Advance Care Planning intervention is likely to clarify the understanding of the goals of care by patients, to help with ACP documentation and and potentially to modify the trajectory of illness for patients during and after hospitalization.

PREVOIR is a randomized, single-center, two-arm trial: patients from experimental arm will benefit from a systematic interview on the care plan whereas patients from control arm will received standard cares.

Feasibility of an Advance Care Planning Intervention

A Prospective, Randomized Trial Assessing the Feasibility of an Advance Care Planning Intervention for Patients Hospitalized in a French Cancer Center

Prevalence of antineoplastic treatment received within the 3 months that precede death

Recording of patient site of death, if applicable

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
An Inpatient Advance Care Planning Intervention for Older Patients With Hematologic Malignancies	NCT05433090	Hematologic Mal...	Inpatient serio...	60 Years -	University of Rochester
Feasibility of an Advance Care Planning Intervention	NCT06149312	Neoplasms	Advance Care Pl...	18 Years -	Institut de cancérologie Strasbourg Europe

Spots Global Cancer Trial Database for advance care planning intervention