A recent study found patients and doctors talked more about their goals for care when primed for such a conversation immediately before an outpatient visit. It also found an increase in patient-reported quality of those discussions, according to JAMA Network.
After asking patients about preferences, barriers and facilitators to communicate about end-of-life care, Jumpstart-Tips created a personalized sheet for each patient that prepared the clinician for the appointment. A separate patient-specific, one-page document was also sent to the patient.
The study authors said this kind of intervention that "primes patients with serious illness and outpatient clinicians might be considered in the clinical setting to increase goals-of-care conversations.”
Physician-patient communication and engagement play a key role in healthcare, but it can be difficult for providers. This is especially the case when discussing end-of-life care. However, there is growing technology and research to find ways to make this easier for clinicians, including Jumpstart-Tips.
Providers are also trying to improve their engagement with patients as healthcare services increasingly incorporate a consumer angle. Some offices try online portals or texting to ease communication and prompt patients for tasks like taking medicine or scheduling a follow-up appointment.
The study of 132 clinicians and 537 patients between 2012 and 2016 explored whether interventions can improve communication. What the study authors found was that 74% of the intervention group said their clinicians had goals-of-care conversations during routine visits compared to 31% in the usual care group.
The program used an algorithm to tailor communication for each specific patient based on their answers to questions about discussing care. Doctors were given this insight before appointments. “The goal of this intervention was to prime clinicians and patients for a brief discussion of goals of care during a routine clinic visit,” the study authors wrote.
In an associated commentary in JAMA, Joanna Paladino and Rachelle Bernacki, who are both from Brigham and Women’s Hospital, Harvard T. H. Chan School of Public Health in Boston, wrote that clinicians know they should discuss goals of care with seriously ill patients. However, physicians question when best to start that discussion and what words to use. They continued that patients with serious illness often don’t receive the care that mirrors their goals, which can hurt quality of life.
Paladino and Bernacki added that the latest report findings “may very well provide a scalable path forward to increase access to these critical conversations."