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4. Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer: The VOICE Randomized Clinical Trial.

Author

Epstein, Ronald M, Duberstein, Paul R, Fenton, Joshua J, Fiscella, Kevin, Hoerger, Michael, Tancredi, Daniel J, Xing, Guibo, Gramling, Robert, Mohile, Supriya, Franks, Peter, Kaesberg, Paul, Plumb, Sandy, Cipri, Camille S, Street, Richard L, Shields, Cleveland G, Back, Anthony L, Butow, Phyllis, Walczak, Adam, Tattersall, Martin, Venuti, Alison, Sullivan, Peter, Robinson, Mark, Hoh, Beth, Lewis, Linda, and Kravitz, Richard L

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Behavioral and Social Science, Clinical Research, Health Services, Clinical Trials and Supportive Activities, Cancer, 7.1 Individual care needs, 7.3 Management and decision making, Good Health and Well Being, Adult, Aged, Caregivers, Female, Humans, Male, Middle Aged, Neoplasm Staging, Neoplasms, Oncologists, Patient Acceptance of Health Care, Patient Participation, Patient-Centered Care, Physician-Patient Relations, Quality of Life, Public Health and Health Services, Oncology and carcinogenesis
Abstract

ImportanceObservational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported.ObjectiveTo determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life.Design, setting, and participantsCluster RCT at community- and hospital-based cancer clinics in Western New York and Northern California; 38 medical oncologists (mean age 44.6 years; 11 (29%) female) and 265 community-dwelling adult patients with advanced nonhematologic cancer participated (mean age, 64.4 years, 146 [55.0%] female, 235 [89%] white; enrolled August 2012 to June 2014; followed for 3 years); 194 patients had participating caregivers.InterventionsOncologists received individualized communication training using standardized patient instructors while patients received question prompt lists and individualized communication coaching to identify issues to address during an upcoming oncologist visit. Both interventions focused on engaging patients in consultations, responding to emotions, informing patients about prognosis and treatment choices, and balanced framing of information. Control participants received no training.Main outcomes and measuresThe prespecified primary outcome was a composite measure of patient-centered communication coded from audio recordings of the first oncologist visit following patient coaching (intervention group) or enrollment (control). Secondary outcomes included the patient-physician relationship, shared understanding of prognosis, QOL, and aggressive treatments and hospice use in the last 30 days of life.ResultsData from 38 oncologists (19 randomized to intervention) and 265 patients (130 intervention) were analyzed. In fully adjusted models, the intervention resulted in clinically and statistically significant improvements in the primary physician-patient communication end point (adjusted intervention effect, 0.34; 95% CI, 0.06-0.62; P = .02). Differences in secondary outcomes were not statistically significant.Conclusions and relevanceA combined intervention that included oncologist communication training and coaching for patients with advanced cancer was effective in improving patient-centered communication but did not affect secondary outcomes.Trial registrationclinicaltrials.gov Identifier: NCT01485627.

Published
2017

6. Cediranib in patients with alveolar soft-part sarcoma (CASPS): a double-blind, placebo-controlled, randomised, phase 2 trial

Author

Judson, Ian, Morden, James P, Kilburn, Lucy, Leahy, Michael, Benson, Charlotte, Bhadri, Vivek, Campbell-Hewson, Quentin, Cubedo, Ricardo, Dangoor, Adam, Fox, Lisa, Hennig, Ivo, Jarman, Katy, Joubert, Warren, Kernaghan, Sarah, López Pousa, Antonio, McNeil, Catriona, Seddon, Beatrice, Snowdon, Claire, Tattersall, Martin, Toms, Christy, Martinez Trufero, Javier, and Bliss, Judith M

Published
2019
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7. Nilotinib in locally advanced pigmented villonodular synovitis: a multicentre, open-label, single-arm, phase 2 trial

Author

Gelderblom, Hans, Cropet, Claire, Chevreau, Christine, Boyle, Richard, Tattersall, Martin, Stacchiotti, Silvia, Italiano, Antoine, Piperno-Neumann, Sophie, Le Cesne, Axel, Ferraresi, Virginia, Penel, Nicolas, Duffaud, Florence, Cassier, Philippe, Toulmonde, Maud, Casali, Paolo, Taieb, Sophie, Guillemaut, Séverine, Metzger, Séverine, Pérol, David, and Blay, Jean-Yves

Published
2018
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21. Author reply

Author

Johnson, Stephanie, Kerridge, Ian, Butow, Phyllis N., and Tattersall, Martin H. N.

Published
2017
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22. Shared Decision Making in Cancer Care

Author

Butow, Phyllis and Tattersall, Martin

Abstract

Cancer treatment outcomes have improved over the past 20 years, but treatment decision making in this context remains complex. There are often a number of reasonable treatment alternatives, including no treatment in some circumstances. Patients and doctors often have to weigh up uncertain benefits against uncertain costs. Shared decision making has been espoused as the appropriate model where there is more than one treatment alternative and patient values should determine the optimal choice. Several studies have demonstrated positive outcomes of shared decision making. However, there are a number of barriers to shared decision making, and patients may feel unable to participate. The doctor's willingness and skills in facilitating patient involvement are likely to be critical. A number of interventions have been reported in the literature, but these tend to target either the doctor (communication skills training) or the patient (decision aids, information booklets and question prompt lists). The next generation of interventions will need to target both parties in facilitating a joint approach to decision making.

Published
2005
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25. Shared decision making in Australia in 2011

Author

McCaffery, Kirsten J., Smith, Sian, Shepherd, Heather L., Sze, Ming, Dhillon, Haryana, Jansen, Jesse, Juraskova, Ilona, Butow, Phyllis N., Trevena, Lyndal, Carey, Karen, Tattersall, Martin H.N., and Barratt, Alexandra

Published
2011
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