BC/WC Communication Tool for Cancer Decision Making in Older Adults

No longer recruiting at 2 trial locations

Overseen By Caroline Eskandar

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Disqualifiers: Second opinion only, Phone discussion, Other study, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a special communication tool can help older adults with cancer make better treatment decisions with their doctors. The study will train oncologists to use the Best Case/Worst Case-Geriatric Oncology (BC/WC-GeriOnc) communication tool to improve discussions about treatment options. It suits patients aged 65 and older with a solid tumor diagnosis who are preparing for a treatment discussion with their doctor. As an unphased trial, it provides a unique opportunity for patients to contribute to research that could enhance doctor-patient communication and decision-making.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on communication tools rather than medication changes.

What prior data suggests that the BC/WC-GeriOnc communication tool is safe for use in cancer decision-making with older adults?

Research has shown that the Best Case/Worst Case-Geriatric Oncology (BC/WC-GeriOnc) tool aids doctors and older cancer patients in discussing treatment options. This tool promotes shared decision-making, enabling doctors and patients to collaborate on selecting the best treatment plan.

Studies have found that patients and their caregivers value the BC/WC-GeriOnc tool, as it clarifies different treatment choices. Importantly, using this tool does not involve taking medicines or undergoing medical procedures, so it carries no physical risks or side effects.

Overall, the BC/WC-GeriOnc tool is considered safe because it focuses on enhancing communication between doctors and patients. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the BC/WC-GeriOnc communication tool because it aims to enhance decision-making for older adults with cancer, a group that often faces complex treatment choices. Unlike traditional methods, which may lack structured guidance, this tool provides a structured framework to clearly present the best and worst-case scenarios, improving understanding and communication between patients, caregivers, and oncologists. By focusing on personalized decision-making, the tool could lead to more informed choices that align with patients' values and preferences, potentially improving satisfaction and outcomes in cancer care.

What evidence suggests that the BC/WC-GeriOnc communication tool is effective for cancer decision-making in older adults?

Studies have shown that the Best Case/Worst Case-Geriatric Oncology (BC/WC-GeriOnc) communication tool helps older adults with cancer make treatment decisions. It aids patients in understanding their options and selecting what suits them best. This tool uses simple pictures to illustrate different treatment outcomes, simplifying complex information. In this trial, some participants will join the intervention group using the BC/WC-GeriOnc tool, while others will be in a waitlist control group receiving usual care. This approach enhances shared decision-making, as patients feel more involved in their care decisions. Research indicates that doctors find the tool practical and acceptable for patient discussions. ^{2 3 6 7 8}

Who Is on the Research Team?

Rebecca Debouer, MD, MA

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for older adults aged 65 or above with any stage of solid tumor cancer, who are about to make a treatment decision. They must be able to understand and consent to the study, have adequate mental capacity, and speak English. Oncologists participating need to treat at least 10 such patients annually and commit to the study's duration.

Inclusion Criteria

My health status, organ function, or other illnesses do not affect my eligibility.

You will need to meet with a medical oncologist in person or through a video call to discuss your treatment options.

I have been diagnosed with a solid tumor cancer at any stage.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Lead-In

Oncologists complete BC/WC-GeriOnc communication tool training and record decision-making discussions with patients

1 month

Multiple visits for training and discussions

Cluster Randomized Trial (CRT)

Oncologists are randomized to intervention or control, with decision-making discussions recorded and questionnaires completed

2 months

Multiple visits for discussions and questionnaires

Follow-up

Participants and caregivers complete follow-up questionnaires and interviews about decision-making and communication

2 months

1 semi-structured interview

What Are the Treatments Tested in This Trial?

Interventions

• Best Case/Worst Case-Geriatric Oncology (BC/WC-GeriOnc) communication tool

Trial Overview The trial tests a communication tool called BC/WC-GeriOnc designed for oncologists when discussing treatment options with elderly cancer patients. It aims to see if training doctors in this method is practical and well-received in real-world settings.

How Is the Trial Designed?

Group I: Lead-In (BC/WC-GeriOnc) Experimental Treatment 1 Intervention

Lead-in phase oncologists will complete the BC/WC-GeriOnc communication tool training. Cancer treatment decision-making discussions will be recorded with 2 patients per oncologist and ask patients and oncologists to complete study questionnaires over one-month follow-up and one semi-structured interview about the decision-making process and communication.

Group II: Intervention (BC/WC-GeriOnc) Experimental Treatment 1 Intervention

Intervention group oncologists will complete the BC/WC-GeriOnc communication tool training. Cancer treatment decision-making discussions will be recorded with 2 patients per oncologist to understand baseline oncologist practices and communication. Patients and oncologists will be asked to complete study questionnaires over a 2 month follow-up and 1 semi-structured interview. For each randomized oncologist, cancer treatment decision-making discussions will be recorded with 5 patients per oncologist. Both patients and oncologists will also be asked to complete study questionnaires over a 2 month follow-up and 1 semi-structured interview about the decision-making process and communication. Each patient will be given the option to select 1 caregiver to participate. Caregivers will be asked to complete study questionnaires and a semi-structured interview about their decision-making experience.

Group III: Waitlist Control Active Control 1 Intervention

Usual care will be provided to the patients, with optional training for the oncologists at study completion.

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Mount Zion Health Fund

Collaborator

Trials

13

Recruited

930+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/35123919/

You have to be sure that the patient has the full picture - PubMed The BC/WC tool is a promising strategy that may improve SDM in geriatric oncology and patient understanding of alternative options and treatment goals.

2. dailynews.ascopubs.org dailynews.ascopubs.org/do/best-case-worst-case-geriatric-oncology-communication-tool-supports-shared-decision

The Best Case/Worst Case-Geriatric Oncology ... The Best Case/Worst Case-Geriatric Oncology (BC/WC-GeriOnc) is a conversation framework and graphic aid tailored for older adults with cancer.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9232997/

Adaptation of the Best Case/Worst Case communication ... We aimed to adapt the Best Case/Worst Case (BC/WC) communication tool, which improves SDM in geriatric surgery, to geriatric oncology.

4. asco.org asco.org/abstracts-presentations/ABSTRACT470198

Cluster randomized pilot of the Best Case/Worst ... Conclusions: It was feasible and acceptable for oncologists to use BC/WC-GeriOnc to support SDM for older adults with cancer. Promising patient-reported SDM and ...

5. sciencedirect.com sciencedirect.com/science/article/am/pii/S1879406822000157

Case/Worst Case communication tool for geriatric oncology cancer care choices, explore tradeoffs and picture potential outcomes, and deliberate about. 59 decisions based on their goals, preferences, and values.

6. ascopubs.org ascopubs.org/doi/10.1200/OP.2024.20.10_suppl.226

Cluster randomized pilot of the Best Case/Worst ... BC/WC-GeriOnc is a conversation framework and graphic aid that supports shared decision making (SDM) between oncologists and older adults with cancer.

7. divisionofresearch.kaiserpermanente.org divisionofresearch.kaiserpermanente.org/in_the_news/the-best-case-worst-case-geriatric-oncology-communication-tool-supports-shared-decision-making-among-older-adults-with-cancer/

The Best Case/Worst Case-Geriatric Oncology ... The Best Case/Worst Case-Geriatric Oncology Communication Tool Supports Shared Decision-Making Among Older Adults With Cancer.

8. researchgate.net researchgate.net/publication/384531487_Cluster_randomized_pilot_of_the_Best_CaseWorst_Case-Geriatric_Oncology_BCWC-GeriOnc_communication_tool_for_older_adults_with_cancer

Cluster randomized pilot of the Best Case/Worst ... 226 Background: BC/WC-GeriOnc is a conversation framework and graphic aid that supports shared decision making (SDM) between oncologists and older adults ...