Communicating Oncologic Prognosis with Empathy (COPE): Evaluation of a standardized, interprofessional instrument  (2019)

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Co-Principal Investigator: Boone W. Goodgame, MD

Clear communication between patients and healthcare providers is a cornerstone to enhancing patient outcomes.  Communication about goals of care has been shown to improve patient outcomes, lead to enhanced quality of life, decrease non-beneficial medical care, provide care consistent with patient goals and wishes, and is cost effective.  Additionally, the current healthcare system has placed a greater emphasis on interprofessional collaboration in the provision of healthcare. Interprofessional education and collaboration can decrease costs, improve patient/population health outcomes, and can improve patient communication regarding goals and outcomes.

However, past studies have shown that communicating prognosis accurately to patients with cancer is particularly difficult. Current value based models, based on the Institute of Medicine cancer quality recommendations, require a written discussion of prognosis, but no validated discussion tools exist to clearly provide patients an understanding of their prognosis.

This study’s goal is to evaluate an interprofessional communication guide, Communicating Oncologic Prognosis with Empathy (COPE), for discussing prognosis and treatment options for cancer patients. Specifically, the researchers aim to:

  1. Refine the COPE instrument based on feedback from additional providers.
  2. Evaluate the feasibility of using the COPE instrument for discussing prognosis with cancer patients.
  3. Measure the COPE instrument’s efficacy in educating patients on their prognosis and improving patient experience of communication with the provider team.

The COPE communication guide will be implemented with 30 patients with curable and 30 patients with noncurable cancer. These patients will be identified through physicians and nurse research staff at outpatient Seton oncology clinics. Providers will complete the COPE instrument with patients who are facing any significant treatment decision.

This pilot study will evaluate a critically needed interprofessional guide to enhance patient understanding and provider communication in one of the most difficult areas of medicine. Improved communication concerning incurable disease is essential for improving value. If successful, this guide will subsequently be evaluated in a national, multi-institutional study, as well as a large regional study in collaboration with two large Central Texas oncology practices.  The investigators’ eventual goal is to develop a tool that will become the standard of care for discussions of cancer prognosis.