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Patient Engagement With Early Stage Advance Care Planning at a Comprehensive Cancer Center
Donna S Zhukovsky1, Pamela Soliman2, Diane Liu3
1Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
The Oncologist
|February 27, 2023
Summary
A social work intervention did not significantly increase advance care planning (ACP) for gynecologic cancer patients selecting a medical decision-maker (MDM). Patient preferences changed frequently, and caregiver understanding of these preferences remained limited.
Area of Science:
- Oncology
- Social Work
- Palliative Care
Background:
- Advance care planning (ACP) is crucial for treatment planning, yet systematic ACP is rare in cancer care.
- Selecting a medical decision-maker (MDM) and establishing care preferences are key components of ACP.
Purpose of the Study:
- To evaluate a systematic social work (SW)-driven process for patients with gynecologic malignancies to select and prepare a medical decision-maker (MDM).
Main Methods:
- A pre/post design study incorporated SW counseling into standard care for new gynecologic cancer patients with a caregiver or existing Medical Power of Attorney (MPOA).
- Questionnaires assessed MPOA document completion at baseline and 3 months, alongside patient values and goals surveys.
Main Results:
- Only 8% of eligible patients without a prior MPOA completed one within 3 months.
- Care preferences shifted in 46% of patients by follow-up.
- Caregiver perception of patient preferences improved from weak to moderate correlation post-intervention.
Conclusions:
- A systematic SW-driven intervention was ineffective in engaging gynecologic cancer patients to select and prepare MDMs.
- Patient care preferences are dynamic, and caregiver understanding of these preferences is only moderately improved.
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