Study finds nudging doctors improves end-of-life conversations with cancer patients
7 reported
A new study examined how to increase serious illness conversations between oncologists and patients with a poor prognosis, testing simple nudges to prompt these discussions. Researchers found that mailing a letter to patients encouraging them to think about such issues made no difference in documented conversations. However, emailing the oncologist before an appointment to suggest the patient may need such a conversation raised the rate of documented conversations. The best results came when both the clinician and patient were nudged simultaneously. The study also revealed that serious illness conversations do not happen as often as warranted, and when they do, they are often not properly documented. The article, written by a doctor reflecting on her own experience with a long-term cancer patient, notes that reminding doctors to have these conversations is useful, but reminding both doctors and patients is even more effective.
What’s reported
Researchers tested two nudges: a letter to the patient and an email to the oncologist before the appointment.
A third cohort received both nudges; a fourth (control) received none.
In the dedicated advance care planning section of medical records, nudging the patient made no difference: just 10% had a documented conversation, same as controls.
With a clinician nudge, the figure rose to 16%; with both nudges, 17%.
When the entire medical record was scanned by AI, 22% of controls and nudged patients had documented conversations.
With a clinician nudge, the figure rose to 28%; with both nudges, 32%.
The article states that serious illness conversations don’t happen as often as warranted, and when they do, they are not appropriately documented.
Key figures
Ranjana Srivastava (doctor and author of the article)
An unnamed long-term cancer patient (described as a survivor who has undergone cancer treatments for 10 years)
Sources: The Guardian
