A randomized, controlled trial of a cardiopulmonary resuscitation (CPR) video decision support tool for seriously ill hospitalized patients with advanced cancer.

Authors

null

Areej El-Jawahri

Massachusetts General Hospital, Boston, MA

Areej El-Jawahri , Jennifer S. Temel , Kavitha Ramchandran , Vicki A. Jackson , Yuchiao Chang , Elizabeth Walker-Corkery , Eileen Mann , Angelo E. Volandes

Organizations

Massachusetts General Hospital, Boston, MA, Massachusetts General Hospital Cancer Center, Boston, MA, Stanford Cancer Institute/Stanford University School of Medicine, Stanford, CA

Research Funding

NIH

Background: Discussing CPR preferences with patients with advanced cancer who are hospitalized is a critical component of end-of-life decision making. However, these discussions are challenging and often avoided by clinicians. We examined the impact of a CPR video decision tool on patients’ choices and knowledge about CPR, and their comfort with watching the video. Methods: We conducted a multi-center randomized controlled trial of 116 patients with advanced cancer hospitalized at two academic oncology centers. We randomized patients to either a 3-minute video describing CPR (n = 52) or standard-oncology care (n = 64). The primary outcome was participants’ preferences for CPR (immediately after viewing the video in the intervention arm). Secondary outcomes included patients’ knowledge (using 5-item questionnaire with higher score reflects greater knowledge), and intervention participants’ comfort with watching the video. Results: The mean age was 66 years (SD = 12); 50% were women, 84% were white, and 48% had lung or gastrointestinal cancer. Only 47% of study participants reported having a discussion about their CPR preferences at the time of admission to the hospital. At baseline, there were no differences in patients’ preferences for not wanting CPR between the intervention and control arms (63% vs. 58%, P = 0.79). After the intervention, participants randomized to the video were more likely not to want CPR (81% vs. 58%, P = 0.03) and were more knowledgeable (mean knowledge score 4.3 vs. 3.2, P < 0.0001) versus control participants. In the intervention arm, 81% of participants found the video helpful, and 94% felt comfortable watching it and would recommend it to others. Conclusions: Seriously ill hospitalized patients with advanced cancer who watched a CPR video decision support tool were more likely not to want CPR and were better informed about their options. Participants reported feeling comfortable watching the video and would recommend it to others facing similar decisions. Video decision support tools can facilitate end-of-life decision-making for hospitalized patients with advanced cancer. Clinical trial information: NCT01527331

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Patient and Survivor Care

Track

Patient and Survivor Care

Sub Track

End-of-Life Care

Clinical Trial Registration Number

NCT01527331

Citation

J Clin Oncol 33, 2015 (suppl; abstr 9516)

DOI

10.1200/jco.2015.33.15_suppl.9516

Abstract #

9516

Poster Bd #

175

Abstract Disclosures

Similar Abstracts

First Author: Areej El-Jawahri

First Author: Areej El-Jawahri

Abstract

2022 ASCO Annual Meeting

Influence of decision support persons on breast cancer treatment decisions among Latinas.

First Author: Krystal A Morales