Addressing misinformation about cancer care in the clinical setting: A pilot study of a conversation guide and training for cancer care providers.

Abstract

e23250 Background: Medical misinformation about cancer care is understudied despite its pervasiveness and harmful effects on patients. This misinformation causes a) delays in care or forgoing of treatment for curable conditions; b) economic harm such as spending and travel on ineffective or harmful treatments; c) potentially toxic effects of the suggested test/treatment; and d) harmful medical interactions with standard curative treatments. Recently, in an IRB study we surveyed MD Anderson clinicians about their ability to successfully address patients who endorse medical misinformation. We found that ~40% of physicians report success rates below 60% for correcting misinformation. ~50% of respondents answered that they have insufficient resources to address patients who endorse misinformation; ~65% answered that they have insufficient training, and ~50% answered that there is insufficient institutional support. In response to these findings, we developed (as far as we know) the first pilot conversation guide and training to improve provider skills and confidence in addressing misinformation about cancer in clinical encounters. Methods: For our quality improvement project, we partnered with clinicians in integrative oncology and gynecologic oncology to develop the conversation guide. The techniques, strategies, and model dialogue in the guide are adapted from best practices developed for addressing vaccine hesitancy. Before the training, we asked 11 physicians to provide a self-assessment of their comfort, confidence, and competence in addressing patients who endorse misinformation about cancer. Then we provided a 25min training in which participants role-played to learn strategies and model dialogue for four common scenarios. After, we resurveyed participants’ self-assessment measures and assessment of the training’s utility. Results: All participants believed the conversation guide and training will be significantly (82%) or moderately (18%) helpful for correcting patients/families who endorse medical misinformation about cancer. 91% said the conversation guide and training significantly (9% moderately) improved their ability to correct patients/patients’ families who endorse medical misinformation. All participants reported improved comfort, confidence, and competence in their ability to address patients/families who endorse misinformation about cancer care. 100% would recommend the guide and training to their peers. Conclusions: Given the prevalence of medical misinformation generally, the training and resources we have developed will be valuable to clinicians effectively address the growing number of patients who endorse misinformation about their care. Our long-term goal is to conduct a larger study and turn our conversation guide and training into a replicable model available for widespread use.