Feasibility and Acceptability of the ABC123 Framework for Advanced Cancer Care: Study Protocol

The ABC123 care planning framework may facilitate an improved understanding of the unique conditions of older adults with advanced cancer and support the creation of an individualized, patient-centered care plan that is both medically feasible and aligned with patients' health, goals, and values.

To present a study protocol designed to (a) assess the preliminary feasibility of ABC123 intervention through recruitment, retention, and clinician feedback, (b) evaluate ABC123 as measured by goal-concordant care, and examine patients' quality of life, value clarity, decisional efficacy, and care team communication over a 6-month period following ABC123 intervention exposure.

This feasibility trial will enroll up to 48 older adults who have advanced cancer that is not curable with surgery and are beginning treatment with an oncologist from one of four clinics in the Denver Metro area. Patients who consent will complete a series of assessments grounded in geriatric, oncologic, and palliative care that make up the ABC123 intervention. Findings from these assessments will be documented in their medical records and shared with their oncologists by an advanced practice provider. Patient participants will be followed for 6 months, with follow-up questionnaires, including a goal-of-treatment question, and interviews administered at 1, 3, and 6 months. Patients' oncologists will also be asked to assess the goal of care for each participant to assess goal alignment.

Since January 2023, 54 potential patient participants have been approached, 29 have enrolled, and 14 have completed the ABC123 intervention and the first follow-up visit.

This study introduces a novel multicomponent care planning intervention for older adults with advanced cancer that implements expert-recommended tools early in a patient's care planning process. The pilot will evaluate its effect on aligning care with patient goals, the feasibility and acceptability of implementation across different oncology clinics, and its potential to guide future pragmatic approaches to improve goal-concordant care.