TY - JOUR
T1 - Primary Palliative Care for Patients with Advanced Hematologic Malignancies
T2 - A Pilot Trial of the SHARE Intervention
AU - Resick, Judith M.
AU - Sefcik, Caroline
AU - Arnold, Robert M.
AU - Leblanc, Thomas W.
AU - Bakitas, Marie
AU - Rosenzweig, Margaret Quinn
AU - Smith, Thomas J.
AU - Dorritie, Kathleen A.
AU - Sehgal, Alison
AU - Im, Annie
AU - Folino, Rose
AU - Tarr, Nicole
AU - Bress, David
AU - Schenker, Yael
N1 - Funding Information:
All visits were completed by the nurse interventionist, and the intervention was integrated into her regular workload, when possible. The nurse interventionist received ongoing coaching and support from the nurse research coordinator. The nurse interventionist completed a checklist for each visit, check-in call, and oncologist check-in. The nurse research coordinator monitored completion of each encounter and listened to audio-recorded intervention visits for key content, providing feedback to the nurse interventionist. Visits were evaluated for content and quality of content (Supplementary Appendix A3).
Publisher Copyright:
© 2021 Mary Ann Liebert Inc.. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: Develop and pilot-test a nurse-led primary palliative care intervention for patients with advanced hematologic malignancies. Background: Nurse-led primary palliative care interventions may improve outpatient palliative care provision for patients with advanced hematologic malignancies. Methods: This two-phase, single-arm pilot study involved patients with recurrent or resistant hematologic malignancies, their caregivers, and oncology clinicians at two US-based urban, university-affiliated oncology clinics. Measurements included feasibility (enrollment rates, intervention fidelity, and outcome assessment rates) and acceptability (patient, caregiver, and clinician surveys). Results: In Phase 1 we developed and implemented an oncology nurse-led primary palliative care intervention for patients with recurrent or resistant hematologic malignancies and their caregivers. In Phase 2, we tested feasibility and acceptability. Twenty-six patient participants enrolled. Consent-to-approach rate was 78% and enrolled-to-consent rate was 84%. All enrolled participants received the intervention per protocol. Sixty-nine percent of patients and 100% of caregivers reported that the intervention helped them better understand the patient's illness and cope. Seventy-five percent of oncologists reported that the intervention improved their patients' quality of care, and 25% reported that it helped them take better care of patients. Conclusions: Although our pilot of oncology nurse-led primary palliative care for patients with advanced hematologic malignancies met some of its secondary feasibility endpoints, it did not meet its primary feasibility endpoint (enrollment) and acceptability was mixed. Protecting nursing staff time, increasing patient and clinician involvement in intervention development, and identifying patients with highest supportive needs may improve feasibility and acceptability of future primary palliative care in hematologic malignancy trials.
AB - Objective: Develop and pilot-test a nurse-led primary palliative care intervention for patients with advanced hematologic malignancies. Background: Nurse-led primary palliative care interventions may improve outpatient palliative care provision for patients with advanced hematologic malignancies. Methods: This two-phase, single-arm pilot study involved patients with recurrent or resistant hematologic malignancies, their caregivers, and oncology clinicians at two US-based urban, university-affiliated oncology clinics. Measurements included feasibility (enrollment rates, intervention fidelity, and outcome assessment rates) and acceptability (patient, caregiver, and clinician surveys). Results: In Phase 1 we developed and implemented an oncology nurse-led primary palliative care intervention for patients with recurrent or resistant hematologic malignancies and their caregivers. In Phase 2, we tested feasibility and acceptability. Twenty-six patient participants enrolled. Consent-to-approach rate was 78% and enrolled-to-consent rate was 84%. All enrolled participants received the intervention per protocol. Sixty-nine percent of patients and 100% of caregivers reported that the intervention helped them better understand the patient's illness and cope. Seventy-five percent of oncologists reported that the intervention improved their patients' quality of care, and 25% reported that it helped them take better care of patients. Conclusions: Although our pilot of oncology nurse-led primary palliative care for patients with advanced hematologic malignancies met some of its secondary feasibility endpoints, it did not meet its primary feasibility endpoint (enrollment) and acceptability was mixed. Protecting nursing staff time, increasing patient and clinician involvement in intervention development, and identifying patients with highest supportive needs may improve feasibility and acceptability of future primary palliative care in hematologic malignancy trials.
KW - advance health care planning
KW - hematologic malignancies
KW - intervention study
KW - palliative care
KW - pilot study
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UR - http://www.scopus.com/inward/citedby.url?scp=85107469031&partnerID=8YFLogxK
U2 - 10.1089/jpm.2020.0407
DO - 10.1089/jpm.2020.0407
M3 - Article
C2 - 33074775
AN - SCOPUS:85107469031
SN - 1096-6218
VL - 24
SP - 820
EP - 829
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
IS - 6
ER -