Clinicians' Perspectives on the Telehealth Serious Illness Care Program for Older Adults With Myeloid Malignancies: Single-Arm Pilot Study

Clinicians' Perspectives on the Telehealth Serious Illness Care Program for Older Adults With Myeloid Malignancies: Single-Arm Pilot Study

Serious illness conversations may help patients avoid unwanted treatments. We previously piloted the telehealth Serious Illness Care Program (SICP) for older adults with acute myeloid leukemia and myelodysplastic syndrome. In this study, we aimed to understand the experience of the telehealth SICP f...

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Bibliographic Details
Published in:JMIR formative research Vol. 8; p. e58503
Main Authors: LoCastro, Marissa, Wang, Ying, Yu, Tristan, Mortaz-Hedjri, Soroush, Mendler, Jason, Norton, Sally, Bernacki, Rachelle, Carroll, Thomas, Klepin, Heidi, Wedow, Lucy, Goonan, Sean, Erdos, Hannah, Bagnato, Brenda, Liesveld, Jane, Huselton, Eric, Kluger, Benzi, Loh, Kah Poh
Format: Journal Article
Language:English
Published: Canada JMIR Publications 27-06-2024
Subjects:
AML
telemedicine
geriatric oncology
tele-health
SICP
Serious Illness Care Program
SIC
oncologist
oncology
metastases
serious illness conversations
acute myeloid leukemia
serious illness conversation
telehealth
cancer
oncologists
myelodysplastic syndrome
MDS
hematologic malignancy
tele-medicine
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Summary:Serious illness conversations may help patients avoid unwanted treatments. We previously piloted the telehealth Serious Illness Care Program (SICP) for older adults with acute myeloid leukemia and myelodysplastic syndrome. In this study, we aimed to understand the experience of the telehealth SICP from the clinician's perspective. We studied 10 clinicians who delivered the telehealth SICP to 20 older adults with acute myeloid leukemia or myelodysplastic syndrome. Quantitative outcomes included confidence and acceptability. Confidence was measured using a 22-item survey (range 1-7; a higher score is better). Acceptability was measured using an 11-item survey (5-point Likert scale). Hypothesis testing was performed at α=.10 (2-tailed) due to the pilot nature and small sample size. Clinicians participated in audio-recorded qualitative interviews at the end of the study to discuss their experience. A total of 8 clinicians completed the confidence measure and 7 clinicians completed the acceptability measure. We found a statistically significant increase in overall confidence (mean increase of 0.5, SD 0.6; P=.03). The largest increase in confidence was in helping families with reconciliation and goodbye (mean 1.4, SD 1.5; P=.04). The majority of clinicians agreed that the format was simple (6/7, 86%) and easy to use (6/7, 86%). Clinicians felt that the telehealth SICP was effective in understanding their patients' values about end-of-life care (7/7, 100%). A total of three qualitative themes emerged: (1) the telehealth SICP deepened relationships and renewed trust; (2) each telehealth SICP visit felt unique and personal in a positive way; and (3) uninterrupted, unrushed time optimized the visit experience. The telehealth SICP increased confidence in having serious illness conversations while deepening patient-clinician relationships. ClinicalTrials.gov NCT04745676; https://www.clinicaltrials.gov/study/NCT04745676.
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ISSN:2561-326X
2561-326X
DOI:10.2196/58503