Targeted reminders increase serious illness conversations in cancer care

The randomized controlled trial out of Dana-Farber Cancer Institute tested two simple nudges designed to encourage important conversations between patients with cancer and their oncologists about goals and preferences for care. One nudge consisted of a reminder email to clinicians prior to patients' appointments and another was a letter and questionnaire mailed to patients. When these nudges were combined, these conversations occurred significantly more often.

The clinical trial was conducted across four cohorts totaling 1,051 patients and 160 clinicians at two academic cancer center sites between December 4, 2022 and September 30, 2024. Adult patients with poor prognosis were randomized to either receive one of the two types of nudges, both nudges, or neither. Patients in the combined nudge arm had 79% higher odds of having a serious illness conversation documented as advance care planning within 60 days over the no-nudge group. The single-nudge groups also showed a modest increase, though not statistically significant.

The researchers deliberately limited the nudges to only patients starting a treatment that is associated with a poor prognosis and capped them at three visits.

Source:

National Comprehensive Cancer Network

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