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Randomized Controlled Trial
. 2013 Apr 9:13:188.
doi: 10.1186/1471-2407-13-188.

Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers

Michael Hoerger  1 , Ronald M Epstein, Paul C Winters, Kevin Fiscella, Paul R Duberstein, Robert Gramling, Phyllis N Butow, Supriya G Mohile, Paul R Kaesberg, Wan Tang, Sandy Plumb, Adam Walczak, Anthony L Back, Daniel Tancredi, Alison Venuti, Camille Cipri, Gisela Escalera, Carol Ferro, Don Gaudion, Beth Hoh, Blair Leatherwood, Linda Lewis, Mark Robinson, Peter Sullivan, Richard L Kravitz
Affiliations
Randomized Controlled Trial

Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers

Michael Hoerger et al. BMC Cancer. .

Abstract

Background: Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers.

Methods/design: The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years.

Discussion: The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes).

Trial registration: Clinical Trials Identifier: NCT01485627.

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Figures

Figure 1
Figure 1
Ecological model of patient-centered communication.
Figure 2
Figure 2
VOICE study design.
See this image and copyright information in PMC

References

    1. Epstein RM, Street RL. , Jr. Patient-centered communication in cancer care: Promoting healing and reducing suffering. Bethesda, MD: National Cancer Institute, NIH; 2007.
    1. Parker SM, Clayton JM, Hancock K. A systematic review of prognostic/end-of-life communication with adults in advanced stages of a life-limiting illness: Patient/caregiver preferences for the content, style, and timing of information. J Pain Symptom Manage. 2007;34:81–93. doi: 10.1016/j.jpainsymman.2006.09.035. - DOI - PubMed
    1. Wright AA, Zhang B, Ray A. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. J Am Med Assoc. 2008;300:1665–1673. doi: 10.1001/jama.300.14.1665. - DOI - PMC - PubMed
    1. Weeks JC, Catalano PJ, Cronin A. Patients’ expectations about effects of chemotherapy for advanced cancer. N Engl J Med. 2012;367:1616–1625. doi: 10.1056/NEJMoa1204410. - DOI - PMC - PubMed
    1. Weeks JC, Cook EF, O’Day SJ. Relationship between cancer patients’ predictions of prognosis and their treatment preferences. J Am Med Assoc. 1998;279:1709–1714. doi: 10.1001/jama.279.21.1709. - DOI - PubMed

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