CONCORD coaching intervention: The care coach will focus on improving readiness and preparedness for components that will be discussed during serious illness conversations (SICs) - (disease understanding/prognosis, fear/worry, goals of care, treatment expectations, informational preferences, trade-offs, caregiver involvement). The coach will also equip patients with basic tools for treatment decision-making and advanced care planning (ACP). The session will be conducted in-person over 30-to-45 minutes. All coaching content is adapted from the serious illness care program developed by Ariadne Labs. This includes an adapted version of the advanced cancer and surgery question prompt list, elements of the serious illness conversations and the "What Matters to Me" serious illness care program booklet. The SICs are conducted at least 12 hours prior to palliative intervention and findings conveyed to surgical team. Coaching sessions would be focused on decision-making and future planning aspects of palliative care.
Study summary
This study aims to evaluate the effectiveness of a serious illness coaching intervention (CONCORD) in improving quality of serious illness conversation (SIC), treatment decision-making, goal-concordant care delivery and quality of life in patients with advanced cancer considered for palliative interventions. CONCORD will be delivered by lay healthcare providers. We compare outcomes between participants receiving CONCORD vs usual care.
Eligibility
Sex
ALL
Min age
21 Years
Max age
99 Years
Healthy volunteers
No
Inclusion Criteria:
(i) Patient:
1. Aged 21 or above;
2. Diagnosis of advanced cancer, i.e. stage 3 or 4 solid organ
3. Consulted for palliative surgery or other interventions, i.e. procedures aimed at relieving symptoms and improving quality of life
4. Able to speak English or Mandarin;
(ii) Caregiver
1. Aged 21 or above;
2. Self-endorsed or identified by the enrolled patient as an unpaid spouse/partner, relative or friend who knows them well and who provides regular care, who does not have to live in the same dwelling
3. Able to speak English or Mandarin.
Exclusion Criteria:
(i). Patient
1. Patient refusal,
2. Active mental illness or severe dementia, or being certified unfit to make medical decision by a specialist physician,
3. Pregnant Women
(ii). Caregiver
1. Self-reported severe mental illness, dementia, active suicidal ideation, uncorrected hearing loss;
2. Unable to complete caregiver-reported outcomes.
Primary outcome measure(s)
Quality of serious illness conversations (SIC) with patients — Baseline 1 (pre-coaching), Baseline 2 (post-coaching), 1 month, 3 months, 6 months after Baseline 1 (pre-coaching) We measured the quality of the SIC conducted based on number of components explored. The seven components explored were disease understanding/prognosis, fear/worry, goals of care, treatment expectations, informational preferences, trade-offs, caregiver involvement. The team will ask questions from Serious Illness Conversations Guide (Ariadne Labs), which enable Healthcare providers to understand patients' values and goals. This would be used as part of a palliative care delivery quality indicator. Team members will share with the caregivers of the patient's goals and palliative care needs when the patient is being coached by the care coach.
Trial sites (1)
Facility
City
Region
Status
Singapore General Hospital
Singapore
Singapore
Recruiting
More Singapore General Hospital trials in Singapore
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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