When both patients and providers receive reminders about end-of-life goals and care preferences, patients have 79% higher odds of an advance care planning conversation occurring within 60 days, according to a study published in JNCCN — Journal of the National Comprehensive Cancer Network.
Researchers from Boston-based Dana-Farber Cancer Institute tested the targeted prompts — or nudges — on 1,051 adult patients with poor prognoses and 160 clinicians between Dec. 4, 2022, and Sept. 30, 2024.
Here are three notes from the study:
- The study cohort was divided into four groups. In one group, providers received a reminder email before a patient’s appointment. In another, patients received a letter and questionnaire in the mail. In the third group, both providers and patients received their respective nudges. The remaining group did not receive either nudge.
- While patients in the combined nudge group had 79% higher odds of having a serious illness conversation documented as advance care planning within 60 days, the single-nudge groups also showed a modest increase, though researchers said the increase was not statistically significant.
- “The key is precision,” co-lead author Cody Cotner, MD, a clinical fellow at Dana-Farber, said in a June 15 news release from the National Comprehensive Cancer Network. “Nudging clinicians at the right time for the right patient rather than blasting reminders for every patient is how we turn this into a helpful quality improvement initiative rather than a burdensome email. Burnout is real and alert fatigue undermines the goal of these nudges: When they feel like noise, they get ignored.”
Read the full study here.
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