Clinician- and Patient-Directed Communication Strategies for Patients With Cancer at High Mortality Risk: A Cluster Randomized Trial.

Samuel U Takvorian¹, Peter Gabriel¹, E Paul Wileyto¹, Daniel Blumenthal¹, Sharon Tejada¹, Alicia B W Clifton^1,2, David A Asch¹, Alison M Buttenheim^1,3, Katharine A Rendle¹, Rachel C Shelton⁴, Krisda H Chaiyachati^1,5, Oluwadamilola M Fayanju¹, Susan Ware¹, Lynn M Schuchter¹, Pallavi Kumar¹, Tasnim Salam^1,6, Adina Lieberman¹, Daniel Ragusano^1,7, Anna-Marika Bauer^1,8, Callie A Scott^1,9, Lawrence N Shulman¹, Robert Schnoll¹, Rinad S Beidas¹⁰, Justin E Bekelman¹, Ravi B Parikh¹

¹Perelman School of Medicine, University of Pennsylvania, Philadelphia.

²Wicked Saints Studios, Medford, Oregon.

³School of Nursing, University of Pennsylvania, Philadelphia.

⁴Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.

⁵Verily Life Sciences, San Francisco, California.

⁶New Jersey Department of Health Communicable Disease Service, Trenton, New Jersey.

⁷School of Medicine, American University of the Caribbean, Cupecoy, Sint Maarten.

⁸Critical Path Institute, Tucson, Arizona.

⁹Cohere Health, Ann Arbor, Michigan.

¹⁰Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

PubMed PMC DOI PDF

Abstract

IMPORTANCE: Serious illness conversations (SICs) that elicit patients' values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. OBJECTIVE: To test the independent and combined effects of cl…

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