Educational intervention does not improve understanding of noncurative intent

  • Enzinger AC & al.
  • JAMA Oncol
  • 16 Jul 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • Videos and booklets providing information about outcomes and prognosis for patients receiving palliative chemotherapy are no better than usual care at improving their understanding that treatment is unlikely to be curative.

Why this matters

  • Patients with advanced disease often receive palliative chemotherapy without understanding that the likelihood of cure is remote.

Study design

  • Patients with advanced colorectal or pancreatic cancer were randomly assigned to intervention (n=92) or usual care (n=94).
  • The intervention group received 5 regimen-specific booklets with 5 companion videos that clearly highlighted the noncurative intent of palliative chemotherapy. 
  • Funding: National Cancer Institute; others.

Key results

  • 49.1% of patients in the intervention group responded that palliative chemotherapy was "not at all likely" to cure their cancer vs 52.9% in the usual-care group (P=.64).
  • The majority of the patients wanted "a lot" of information or "as much information as possible" regarding adverse effects (80.1%), the likelihood of cure (79.6%), and prognosis (79.6%). 
  • The intervention group was likely to have an accurate understanding of adverse effects vs the usual-care group (56% vs 40.2%; P=.05), but the result did not meet the statistical significance threshold of P<.05.>
  • The intervention group was no more likely to be distressed by the materials than the usual-care group.

Limitations

  • Patients were not incentivized or given assistance in working through the materials.