Giving information strategically and transparently : A pilot trial of the Oncolo-GIST intervention to promote patients' prognostic understanding
© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd..
PURPOSE: Most patients with cancer lack the prognostic understanding necessary to make informed decisions. We tested the feasibility and acceptability of the Oncolo-GIST ("Giving Information Strategically and Transparently, GIST") intervention and explored its associations with patients' improved prognostic understanding.
METHODS: The Oncolo-GIST intervention distills prognostic discussions into easy-to-understand talking points. Patients with metastatic cancers that progressed on ≥1 line of chemotherapy and not expected to survive 12 months (n = 31) were recruited from October 2020 through November 2022. We compared patients who discussed their progressive scans with an oncologist trained in the GIST technique or not (i.e., usual care). A primary outcome was prognostic understanding (e.g., patients reporting a life-expectancy of months) assessed within a week of the scan discussion visit.
RESULTS: Oncologists (n = 4) appeared receptive to the Oncolo-GIST intervention and scored nearly perfectly on post-training tests of material mastery after a < 2-h tutorial. Post-scan discussion visit, 100% of patients who met with an Oncolo-GIST-trained clinician understood that their cancer was considered incurable (a 31% improvement from pre-visit) compared with 91% of patients meeting with usual care oncologists (an 18% improvement); 33% of patients who met with an Oncolo-GIST-trained oncologist understood that they likely had months, not years, compared to 18% in the usual care group. No statistically significant differences emerged for these changes, nor for therapeutic alliance, anxiety, or depression scores between groups.
CONCLUSION: Oncolo-GIST appears to be an easily learned approach to improve prognostic understanding that neither undermines therapeutic alliances nor increases patients' anxiety or depressive symptoms. Efficacy testing in a larger trial is warranted.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
|---|---|
| Enthalten in: |
Cancer medicine - 12(2023), 17 vom: 01. Sept., Seite 18269-18280 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Prigerson, Holly G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cancer |
|---|
| Anmerkungen: |
Date Completed 18.12.2023 Date Revised 23.01.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/cam4.6420 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360508073 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360508073 | ||
| 003 | DE-627 | ||
| 005 | 20240124231921.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/cam4.6420 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1269.xml |
| 035 | |a (DE-627)NLM360508073 | ||
| 035 | |a (NLM)37551156 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Prigerson, Holly G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Giving information strategically and transparently |b A pilot trial of the Oncolo-GIST intervention to promote patients' prognostic understanding |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.12.2023 | ||
| 500 | |a Date Revised 23.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. | ||
| 520 | |a PURPOSE: Most patients with cancer lack the prognostic understanding necessary to make informed decisions. We tested the feasibility and acceptability of the Oncolo-GIST ("Giving Information Strategically and Transparently, GIST") intervention and explored its associations with patients' improved prognostic understanding | ||
| 520 | |a METHODS: The Oncolo-GIST intervention distills prognostic discussions into easy-to-understand talking points. Patients with metastatic cancers that progressed on ≥1 line of chemotherapy and not expected to survive 12 months (n = 31) were recruited from October 2020 through November 2022. We compared patients who discussed their progressive scans with an oncologist trained in the GIST technique or not (i.e., usual care). A primary outcome was prognostic understanding (e.g., patients reporting a life-expectancy of months) assessed within a week of the scan discussion visit | ||
| 520 | |a RESULTS: Oncologists (n = 4) appeared receptive to the Oncolo-GIST intervention and scored nearly perfectly on post-training tests of material mastery after a < 2-h tutorial. Post-scan discussion visit, 100% of patients who met with an Oncolo-GIST-trained clinician understood that their cancer was considered incurable (a 31% improvement from pre-visit) compared with 91% of patients meeting with usual care oncologists (an 18% improvement); 33% of patients who met with an Oncolo-GIST-trained oncologist understood that they likely had months, not years, compared to 18% in the usual care group. No statistically significant differences emerged for these changes, nor for therapeutic alliance, anxiety, or depression scores between groups | ||
| 520 | |a CONCLUSION: Oncolo-GIST appears to be an easily learned approach to improve prognostic understanding that neither undermines therapeutic alliances nor increases patients' anxiety or depressive symptoms. Efficacy testing in a larger trial is warranted | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a communication intervention | |
| 650 | 4 | |a prognostic understanding | |
| 650 | 4 | |a terminal illness acknowledgment | |
| 700 | 1 | |a Russell, David |e verfasserin |4 aut | |
| 700 | 1 | |a Kakarala, Sophia E |e verfasserin |4 aut | |
| 700 | 1 | |a Derry-Vick, Heather M |e verfasserin |4 aut | |
| 700 | 1 | |a Shah, Manish A |e verfasserin |4 aut | |
| 700 | 1 | |a Saxena, Ashish |e verfasserin |4 aut | |
| 700 | 1 | |a Reyna, Valerie F |e verfasserin |4 aut | |
| 700 | 1 | |a Ocean, Allyson |e verfasserin |4 aut | |
| 700 | 1 | |a Scheff, Ronald |e verfasserin |4 aut | |
| 700 | 1 | |a Maciejewski, Paul K |e verfasserin |4 aut | |
| 700 | 1 | |a Epstein, Andrew S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cancer medicine |d 2012 |g 12(2023), 17 vom: 01. Sept., Seite 18269-18280 |w (DE-627)NLM224388460 |x 2045-7634 |7 nnns |
| 773 | 1 | 8 | |g volume:12 |g year:2023 |g number:17 |g day:01 |g month:09 |g pages:18269-18280 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/cam4.6420 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 12 |j 2023 |e 17 |b 01 |c 09 |h 18269-18280 | ||