A new multicenter study evaluated the effectiveness of an educational program using a video and booklet to communicate the benefits and limitations of palliative chemotherapy (PC) for patients with advanced cancer. However, the program was found to not sufficiently modify patient expectations. Results of the study were published in JAMA Oncology.

The primary outcome of this trial (ClinicalTrials.gov Identifier: NCT02282722) was accurate patient expectations of 3-month chemotherapy benefits for patients receiving PC. This was assessed based on how each patient would answer a question about how likely the chemotherapy was to cure their cancer.

Patients in this study had advanced colorectal or pancreatic cancer, and they were initiating first- or second-line PC. Patients were randomized for inclusion in either a control group receiving usual care (94 patients) or an intervention group receiving a video and booklet–based program about PC (92 patients).

The mean age of patients in this study was 59.3 years (range, 28-86), and the majority of patients (63.4%) had colorectal cancer.


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The intervention and control groups showed similar results for the primary outcome of accurate expectations. Accurate expectations were demonstrated among 52.6% (95% CI, 40.3%-65.0%) in the intervention group, compared with 55.5% (95% CI, 45.1%-66.0%) in the control group. There was a trend toward more accurate understanding of adverse events within the intervention group than in the control group, but this trend was nonsignificant (P =.05).

In a baseline assessment of how much information patients stated they wished to receive about their PC, 80.1% indicated a preference to receive “a lot” or “as much information as possible” regarding adverse events. Nearly as many (79.6%) wanted “a lot” or “as much information as possible” regarding prognosis or likelihood of cure.

The researchers reported that the additional information did not appear to enhance patient distress in the interventional group.

“In this multicenter randomized clinical trial, provision of a multimedia PC educational intervention did not alter patients’ expectations of cure,” concluded the researchers in their report. They recommended considering alternative means of providing information about outcomes to patients, including the involvement of nurses in patient education.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Enzinger AC, Uno H, McCleary N, et al. Effectiveness of a multimedia educational intervention to improve understanding of the risks and benefits of palliative chemotherapy in patients with advanced cancer: a randomized clinical trial [published online July 16, 2020]. JAMA Oncol. doi: 10.1001/jamaoncol.2020.1921