Priming Survey for Cancer

(Prime GOC Trial)

Overseen By Lauren Reed-Guy, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Abramson Cancer Center at Penn Medicine

Disqualifiers: Non-English speakers

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

Compensation: Varies

Number of Visits: 1

80 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new approach to help patients with advanced lung or gastrointestinal cancers discuss their care goals with their doctors. The trial aims to determine if a short survey, given to patients before hospital discharge, can improve discussions about treatment wishes and end-of-life care. Participants will either complete the survey, with their answers shared with their oncology team, or join a group that does not complete the survey. The trial seeks individuals admitted to the hospital unexpectedly with advanced lung or gastrointestinal cancer who are about to be discharged. As an unphased trial, this study offers patients a unique opportunity to contribute to enhancing communication about care goals.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this intervention is safe for patients with advanced lung and gastrointestinal cancers?

A previous study demonstrated that a bidirectional priming intervention improved communication between patients and doctors regarding care goals. This approach involves patients completing a survey about their treatment preferences, which is then shared with their healthcare team. The team receives reminders of these goals, encouraging further conversations between patients and doctors.

Research has shown that patients feel comfortable with this method. No reports of harm or negative effects have emerged from participating in these interventions. The primary aim is to enhance communication, not to introduce new medications or procedures, making it a low-risk way to ensure that patients' care preferences are understood and respected. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Bidirectional Priming Intervention because it offers a fresh approach to cancer care coordination. Unlike traditional methods that may not fully engage patients in their ongoing treatment plans, this intervention involves patients completing a survey before leaving the hospital. The responses are then shared with their outpatient oncology team, aiming to enhance communication and tailor follow-up care more effectively. This method has the potential to improve patient outcomes by ensuring that care is more personalized and responsive to individual needs.

What evidence suggests that this intervention is effective for improving goals-of-care communication in cancer patients?

Research has shown that a Bidirectional Priming Intervention can enhance communication about care goals in patients with advanced cancers. Studies have found that organized methods to encourage these conversations help overcome obstacles and ensure care aligns with patient preferences. In this trial, participants in the intervention arm will complete a survey about their care goals, which will be shared with their doctors. This approach can increase the recording of care goals within 30 days after hospital discharge. The aim is to ensure patients receive care that aligns with their personal wishes. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for hospitalized patients with advanced lung and gastrointestinal cancers. It aims to help them communicate their end-of-life care preferences with oncologists after leaving the hospital. Participants must be willing to complete a survey and have their responses shared with their cancer care team.

Inclusion Criteria

Unplanned admission to the HUP Solid Oncology service

Anticipated discharge within the next 72h

Primary oncologist is based at HUP

Exclusion Criteria

I cannot complete a survey in English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants in the intervention group complete a survey regarding their goals, preferences, and disease understanding. Survey responses are shared with the outpatient oncology team.

Up to 30 days

1 visit (in-person) for survey completion

Follow-up

Participants are monitored for goals-of-care documentation in the electronic medical record within 30 days of hospital discharge.

30 days

What Are the Treatments Tested in This Trial?

Interventions

• Bidirectional Priming Intervention

Trial Overview The study tests if a 'priming' survey can improve discussions about goals of care between patients and doctors. Half the participants will take this survey, which prompts them to think about treatment goals, while the other half won't. Doctors get reminders in their records to talk about these topics during follow-up visits.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Participants in the intervention arm will complete a survey prior to hospital discharge. Their responses will be shared with each participant's outpatient oncology team.

Group II: Control Active Control 1 Intervention

Who Is Running the Clinical Trial?

Abramson Cancer Center at Penn Medicine

Lead Sponsor

Trials

425

Recruited

464,000+

Conquer Cancer Foundation

Collaborator

Trials

22

Recruited

4,000+

Published Research Related to This Trial

In a study of 577 cancer patients, breast cancer patients showed significantly higher rates of non-adherence to adjuvant chemotherapy guidelines compared to colon cancer patients, with rates of 69% for primary non-adherence and 89% for non-persistence at 6 months.

Patient-centered communication (PCCM) was found to be a critical factor influencing adherence, with lower communication scores linked to higher non-adherence, particularly among older patients and those diagnosed with breast cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adjuvant chemotherapy non-adherence, patient-centered communication, and patient-level factors in elderly breast and colon cancer patients. Mitchell, KR., Boyle, JR., Juricekova, L., et al.[2023]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06955468

Evaluating a Bidirectional Priming Intervention for Goals-of- ... This pilot study will evaluate whether an intervention aimed at hospitalized patients with advanced lung and gastrointestinal cancers can help facilitate goals- ...

2. withpower.com withpower.com/trial/phase-gastrointestinal-neoplasms-6-2025-38689

Priming Survey for Cancer · Info for Participants This suggests that treatments like the Bidirectional Priming Intervention, which may involve patient engagement, could be effective in improving cancer care.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10280682/

NETworking with cancer: the bidirectional interplay between ... Here, we discuss the bidirectional interplay by which cancer stimulates NET formation, and NETs in turn support disease progression.

4. sciencedirect.com sciencedirect.com/science/article/pii/S1535610823000119

NETworking with cancer: The bidirectional interplay ... Here, we discuss the bidirectional interplay by which cancer stimulates NET formation, and NETs in turn support disease progression.

5. cell.com cell.com/developmental-cell/fulltext/S1534-5807(24)00338-1

Bidirectional activation of stem-like programs between ... We describe a cancer-dependent chromatin remodeling and activation of developmental programs in alveolar type 2 (AT2) cells within the niche.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT06955468

Evaluating a Bidirectional Priming Intervention for Goals-of ... The primary feasibility outcome is intervention completion rate and the primary clinical outcome is GOC documentation within 30 days of discharge in the ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10201405/

Intervention to Promote Communication About Goals of ... This randomized clinical trial compares the effect of a communication-priming intervention vs usual care on patient-physician discussions on goals of care for ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2949820124000663

Implementing digital patient-reported outcomes in routine ... In this review, we analyze the experiences related to implementation of PROs in routine cancer care that have been published during recent years, focusing ...

9. researchgate.net researchgate.net/publication/334337785_Clinical_Outcomes_of_Pharmaceutical_Interventions_and_Bidirectional_Sharing_of_Patient_Information_between_a_Hospital_and_Community_Pharmacies_in_Outpatient_Chemotherapywailaihuaxueliaofaniokeruyaoxue

Clinical Outcomes of Pharmaceutical Interventions and ... This review describes the clinical outcomes of pharmaceutical interventions and bidirectional sharing of patient information between a hospital and ...

10. nature.com nature.com/articles/s41598-023-39794-z

Bidirectional referral system between National Taiwan ... This research aims to evaluate patient satisfaction with the bidirectional referral. Sixty-six patients have been referred from the emergency ...