Increasing patients' preferences for palliative care through the dissemination of palliative care research: Impact of socioeconomic status, geography, and depression severity.

Abstract

109 Background: Approximately 4 out of 5 Americans are unfamiliar with palliative care, a significant barrier to utilization. Accordingly, providing patients with knowledge could empower them to seek palliative care. As a pilot investigation, the EMPOWER Study examined the impact of a psychoeducational intervention on patients’ preferences for palliative care. Methods: Participants were 581 patients with heterogeneous cancer diagnoses recruited through the NIH-sponsored ResearchMatch program. The study used a between-group pre-post design, completed in a single session via the Internet. Random assignment determined whether participants received psychoeducational information summarizing the results of the Temel et al. (2010) palliative care article, using a plain-language and graphical format. Participants completed measures of their health history, demographics, socioeconomic status (education level, financial strain, subjective financial standing), and depression symptom severity and completed a pre-post measure of preferences for palliative care. Results: Relative to controls, participants receiving the intervention experienced an increase in preferences for palliative care (p < .0001). The standardized mean difference in pre-post change was greater than a standard deviation in magnitude (Cohen’s d = 1.03), a “large” effect size by conventional standards. The intervention showed comparable effects across key patient subgroups, including patients of low socioeconomic status, patients living in low-access states, and patients with greater depression symptom severity. Conclusions: Providing patients with knowledge of recent research findings increased preferences for palliative cancer care. The next step is to develop psychoeducational interventions that are grounded in stakeholder input and incorporate a broader evidence base. This line of research has implications for empowering patients and their families to seek care that can improve quality of life.

Right-to-try laws and individual patient “compassionate use” of experimental oncology medications: A call for improved provider-patient communication

“…Potential approaches might include the use of health coaches and standardized patient instructors to assist patients and providers in practicing communication skills in key areas, such as discussing prognosis and health information, expressing and responding to emotions, and engaging in shared decision making (Hoerger et al, 2013). As well, medical education programs are increasingly being adapted to train these skills (Back et al, 2007), and decision aids may also be useful for increasing patient understanding of palliative care (Hoerger et al, 2015). …”