Neoplasms

Digestive System Diseases

All Conditions

Respiratory Tract (Lung and Bronchial) Diseases

Gland and Hormone Related Diseases

Skin and Connective Tissue Diseases

Symptoms and General Pathology

Rare Diseases

Stomach Neoplasms

Lung Neoplasms

Pancreatic Neoplasms

Melanoma

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Death

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Nerve Tissue

Endocrine Gland Neoplasms

Pancreatic Diseases

Endocrine System Diseases

Astrocytoma

Glioma

Neoplasms, Neuroepithelial

Neoplasms, Glandular and Epithelial

Stomach Diseases

Stomach Cancer

Pancreatic Cancer

Neuroepithelioma

Oncologists trained using OncoTalk to have Goals of Care discussions.

Training of oncologists using OncoTalk to conduct Goals of Care discussions and measure impact on patient satisfaction.

GoC intervention

Nina Bickell, MD, MPH

The goal of this study is to increase and improve Goals of Care discussions for advanced cancer patients by training medical oncologists to conduct these discussions. The investigators will evaluate the GoC discussion's effects on patient satisfaction, receipt of treatment in line with preferences, use of aggressive treatment, and oncologist communication skill.

Among advanced cancer patients, discussions about prognosis, goals of care (GoC) and end-of-life preferences improve quality of life of patients and reduce rates of hospital and ICU admission. Yet, few patients know their chemotherapy treatments will not cure their disease despite nearly all wishing to receive information- good \& bad. Currently, 37% of advanced cancer patients have GoC clarifying discussions and when they do, it is often in the last 2 months of life when symptoms are uncontrollable and oncologists have no other treatments to offer. These discussions do not usually happen with the patient's personal oncologist. Current efforts to teach oncologists such skills are impractical, requiring a lot of time away from their office practice and do not take into account job pressures.

The goal of this study is to increase and improve GoC discussions for advanced cancer patients by training medical oncologists to conduct these discussions and evaluate its effects on patient satisfaction, receipt of care in line with preferences, aggressive care utilization, and oncologist communication skill.

The investigators will recruit 280 patients of which half will come from intervention doctors and the other from the control doctors. The investigators will train randomly selected oncologists to conduct GoC discussion. Patients will be surveyed at baseline within days of their GOC visit and at 6 months. Oncologists will be audio-taped at baseline and after training is complete to assess practice and skill to conduct GoC discussions.

Primary outcomes include patient reported conduct of and satisfaction with GoC discussion. Secondary outcomes include oncologist communication skills, feasibility of performing GoC in the outpatient setting, receipt of care in line with preferences, use of hospice, chemotherapy or ICU in the last 30 days of life.

Improving Goals of Care Discussion in Advanced Cancer Patients

Improving Advanced Cancer Patient-Centered Care by Enabling Goals of Care Discussions

Number of patient's perceptions that goals of care discussions were increased occurred as measured by GoC qualitative patient survey.

Number of Patient's satisfaction with the discussion of improved goals of care as measured by GoC qualitative patient survey.

Oncologist's communication skills are tested and rated between 1 and 7, with higher number indicating the oncologists were more comfortable in demonstrating communication skills while having the Goals of Care discussion with their patients.

Patient-Centered Outcomes Research Institute

Icahn School of Medicine at Mount Sinai

Adverse events were not monitored/assessed

Patients given OncoTalk GoC intervention

GoC intervention: Training of oncologists using OncoTalk to conduct Goals of Care discussions and measure impact on patient satisfaction.

Patients - GoC Intervention

Prospective control group where no intervention was given.

Patients - Usual Care

Oncologists - GoC Intervention

Oncologists not trained using OncoTalk to have Goals of Care discussions.

Oncologists - Usual Care

Total

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Data was collected for patient participants only

Radhi Yagnik

Oncologist - GoC Intervention

Data from patient participants only. Data not collected from Oncologists

Number of Participants Who Perceived Increased Goals of Care Discussions

Patients given OncoTalk GoC intervention.

GoC intervention: Training of oncologists using OncoTalk to conduct Goals of Care discussions and measure impact on patient satisfaction.

Data collected for patient participants only

Number of Patients Perception of Improved Goals of Care Discussions

Oncologists trained using OncoTalk to have Goals of Care discussions.

GoC intervention: Training of oncologists using OncoTalk to conduct Goals of Care discussions and measure impact on patient satisfaction.

Participants represented are the oncologist's. Data collected for the oncologists only.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Improving Goals of Care Discussion in Advanced Cancer Patients	NCT02374255	Primary Stage I... Esophageal Colorectal Canc... Glioblastoma Cancer of Stoma... Cancer of Pancr... Melanoma Head or Neck Ca... Stage III Stage IV Lung Cancers Pancreatic Canc...	GoC interventio...	21 Years -	Icahn School of Medicine at Mount Sinai
Improving Goals of Care Discussion in Advanced Cancer Patients	NCT02374255	Primary Stage I... Esophageal Colorectal Canc... Glioblastoma Cancer of Stoma... Cancer of Pancr... Melanoma Head or Neck Ca... Stage III Stage IV Lung Cancers Pancreatic Canc...	GoC interventio...	21 Years -	Icahn School of Medicine at Mount Sinai

Spots Global Cancer Trial Database for end of life discussions