Neoplasms Clinical Trial
Official title:
Treatment as Usual vs. Additional Collaborative Advance Care Planning to Improve Quality of Life for Palliative Cancer Patients: a Randomized Controlled Trial
This study evaluates the effect of a collaborative advance care planning intervention on the
quality of life in palliative oncological patients. Research indicates, that talking about
wishes for end of life care and death, may improve the quality of life, but can be difficult
for involved parties.
The intervention especially developed for this study trys to reduce psychosocial barriers
that make conversations about these topics difficult. The study will measure the effect of
the intervention on patients and caregivers quality of life.
The study will give additional information about implementation of advance care planning
interventions in different care settings in a complex health care systems.
A high quality of end of life care and a "good death" as part of an improved patient centered
care at the end of life have become important goals of palliative care. To achieve these
goals, patient's preferences for end of life (EOL) care need to be known.
This study (randomized controlled trial) will evaluate effectiveness of a new type of advance
care planning (ACP) intervention in different palliative care settings in Germany. The study
addresses a new concept of ACP called collaborative advance care planning (cACP). This new
concept is focusing on psychosocial barriers of patients and caregivers in addition to a
standardized ACP process in order to reduce distress of patients and care-givers and enhance
the chance of successful ACP-implementation. The main research questions are: a) Can cACP
improve quality of life in palliative patients and caregivers?, b) Does cACP reduce distress
in patients and caregivers and enhance consistency of end-of-life care? and c) Does cACP
improve quality of end of life care and reduce utilization of health care resources? The
investigators will try to answer theses research questions through a so called "randomized
controlled trial" methodology. Admissible palliative cancer patients who are willing to
participate in the trial will be randomly assigned to three groups. The first group will
receive treatment as usual for palliative care patients. The second group will receive
treatment as usual and an unspecific psychological intervention (sham-intervention). The
third group will receive treatment as usual and the intervention designed for this trial.
Both interventions will be equally long in duration and will be delivered by the same
psychologists.
The primary outcome is the quality of life at 16 weeks measured by the internationally
recognized "Functional Assessment of Cancer - General Version (FACT-G)" questionnaire.
Secondary endpoints include measurements of the development of QoL over time, distress,
depression, and the quantity of advance directives in the different groups.
Patients will be recruited in four different recruiting sites: a palliative care ward in an
university hospital, an oncologists office, a rehabilitation clinic, and an outpatient
palliative care network.
The study will recruit 90 patients in every group, 270 patients in total.
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