Communication Improvement Feedback for Cancer Care

Overseen By Natalie Ashley, MHA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve communication between healthcare providers and patients with serious illnesses, such as advanced cancer. Researchers will test whether feedback about communication can help doctors better understand and meet patient needs. The study includes two groups: one will receive feedback, while the other will continue with usual care. Patients at Duke Health may be suitable candidates for this trial. As an unphased trial, this study offers a unique opportunity to enhance patient-doctor communication, potentially improving care for future patients.

Do I need to stop taking my current medications for this trial?

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

What prior data suggests that this communication feedback method is safe for cancer care?

Research has shown that using feedback to improve communication in cancer care is generally well-received. One study found that feedback on doctor-patient interactions can benefit cancer care teams, indicating the approach is safe for patients. Another review examined various feedback methods in healthcare and identified safe practices.

In simpler terms, providing feedback to enhance doctor-patient conversations does not appear harmful. Instead, it can improve communication, which is crucial for patient care. No evidence suggests serious side effects or risks from this type of feedback. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it focuses on enhancing communication in cancer care, which is a key aspect often overlooked in traditional treatment plans. Unlike standard treatments that primarily target the physical aspects of cancer, this approach provides feedback to healthcare providers about their communication frequency and quality with patients. The aim is to improve patient-provider interactions, potentially leading to better patient satisfaction and outcomes. This trial is groundbreaking as it seeks to address the emotional and informational needs of cancer patients, which can be as crucial to recovery as the medical treatments themselves.

What evidence suggests that this feedback is effective for improving communication in cancer care?

Research has shown that providing feedback to healthcare providers about their communication with cancer patients can enhance the care process. In this trial, some participants will be in the intervention arm, where healthcare providers receive feedback on the frequency and quality of their communication. Studies have found that when doctors receive insights into their communication skills, they often improve in discussing important topics with patients. This improvement can lead to clearer conversations, which are crucial in cancer care. However, while communication improvements have been observed, the direct effect on patient health outcomes remains less clear. Better communication can help patients feel more understood and involved in their care decisions. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is open to patients within the Duke Health system who are dealing with advanced serious illnesses such as cancer, heart failure, chronic obstructive pulmonary disease (COPD), or dementia. There are no specific exclusion criteria mentioned, so it appears to be quite inclusive.

Inclusion Criteria

Duke Health patient

Exclusion Criteria

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Feedback to provider regarding frequency and quality of communication

6 months

Control

Usual care without additional interventions

6 months

Follow-up

Participants are monitored for frequency and timing of goals of care communication

2 years

What Are the Treatments Tested in This Trial?

Interventions

• Feedback

Trial Overview

The study focuses on improving communication strategies for patients with serious health conditions. It aims to develop and test methods that ensure patient care aligns with their goals and values.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Feedback to provider regarding frequency and quality of communication

Group II: Control Active Control 1 Intervention

Usual care

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

Published Research Related to This Trial

A systematic review of 96 studies on communication training for oncology professionals highlighted that outcomes like communication confidence, observed skills, and patient satisfaction were commonly assessed, but varied widely across studies.

Experts recommend that future studies should clearly define outcomes linked to specific training objectives and assess them at multiple levels, including those of healthcare professionals, patients, and the interactions between them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes and outcome measures used in evaluation of communication training in oncology - a systematic literature review, an expert workshop, and recommendations for future research. Fischer, F., Helmer, S., Rogge, A., et al.[2023]

In a study of 224 hospitalized oncology patients in Switzerland, 42% experienced at least one adverse event (AE) related to care, with pain and constipation being the most common issues identified.

Among the AEs, 61% were deemed not preventable, highlighting the need for improved safety measures in oncology care to reduce the occurrence of these events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Describing adverse events in Swiss hospitalized oncology patients using the Global Trigger Tool. Gerber, A., Da Silva Lopes, A., Szüts, N., et al.[2022]

A virtual interdisciplinary communication workshop was found to be feasible and acceptable for improving communication among oncology team members, based on feedback from 87 patients and 56 clinicians.

The workshop highlighted areas for improvement in communication practices, suggesting that targeted interventions can enhance patient care and safety in ambulatory oncology settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Evaluation of a Data-Driven, Interactive Workshop to Facilitate Communication and Teamwork in Ambulatory Medical Oncology Settings. Blok, AC., Costa, DK., Wright, NC., et al.[2023]

A new screening tool was developed to identify adverse events (AEs) in cancer care, consisting of 76 specific triggers that can help detect potential safety issues during treatment.

This tool, which categorizes triggers related to general care, vital signs, medications, and laboratory tests, has the potential to improve patient safety and quality of care in oncology, although further testing is needed to validate its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

ReCAP: Detection of Potentially Avoidable Harm in Oncology From Patient Medical Records. Lipitz-Snyderman, A., Weingart, SN., Anderson, C., et al.[2021]

Patient-reported outcome measure (PROM) feedback interventions in oncology showed a positive impact on health-related quality of life (HRQL) and patient-healthcare provider communication, with a moderate effect size based on a meta-analysis of 29 studies involving 7071 cancer patients.

The intervention also demonstrated a significant improvement in 1-year overall survival rates, suggesting that providing feedback can enhance care processes and outcomes for cancer patients, although the findings are limited by a high risk of bias in the studies reviewed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of routine provision of feedback from patient-reported outcome measurements for cancer care improvement: a systematic review and meta-analysis. Lu, SC., Porter, I., Valderas, JM., et al.[2023]

A new tool for clinicians in inpatient oncology units has been developed to prevent adverse events and enhance patient safety, focusing specifically on cancer patients.

The tool includes a catalog of adverse events and a risk map, which helps healthcare providers implement best practices in their daily activities to improve clinical safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving patient safety in the inpatient setting through risk assessment and mitigation. Reche Navarro, MN.[2016]

Citations

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Patient-Reported Outcome Measures as an Intervention

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Assessing Patients' Experiences with Communication ...

The PACE items tap relevant, important aspects of communication during cancer care, and may be useful to cancer care teams desiring detailed feedback.

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journals.plos.org/plosone/article?id=10.1371/journal.pone.0307831

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This review will allow evidence-based conclusions about types and effects of different PFE interventions for transitional safety in oncology care.

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The effectiveness of symptom management interventions ...

The 20 reviews assessing PROM feedback on patient health outcomes in cancer care drew mixed conclusions. Although the overall direction of effect appeared ...

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Reporting feedback on healthcare outcomes to improve ...

This review provides a comprehensive overview of strategies used to implement feedback interventions in a wide range of practice settings.

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Encouraging Patients to Speak up About Problems In ...

This pilot study sought to evaluate the impact of an intervention of active outreach to patients undergoing cancer treatment.