Abstract
BackgroundEarly integration of palliative care concurrently to standard cancer care is associated with several benefits for patients and their caregivers. However, communication barriers on part of the caring physicians often impede a timely referral to palliative care. This study describes the protocol of the evaluation of a communication skills training aiming to strengthen the ability of physicians to address palliative care related topics adequately and early during disease trajectory.MethodsWe will implement a communication skills training and evaluate it within a prospective, multi-centered, two-armed randomized controlled trial (RCT), which will be conducted at four sites in Germany. Eligible subjects are all physicians treating patients with advanced cancer in their daily routine. An intervention group (IG) receiving a group training will be compared to a wait-list control group (CG) receiving the training after completion of data collection. At pre- and post-measurement points, participants will conduct videotaped conversations with standardized simulated patients (SP). Primary outcome will be the external rating of communication skills and consulting competencies addressing palliative care related topics. Secondary outcomes on core concepts of palliative care, basic knowledge, attitudes, confidence and self-efficacy will be assessed by standardized questionnaires and self-developed items. A further external assessment of the quality of physician-patient-interaction will be conducted by the SP. Longitudinal quantitative data will be analyzed using covariate-adjusted linear mixed-models.DiscussionIf the communication skills training proves to be effective, it will provide a feasible intervention to promote an earlier communication of palliative care related topics in the care of advanced cancer patients. This would help to further establish early integration of palliative care as it is recommended by national and international guidelines.Trial registrationGerman Clinical Trials Register DRKS00017025 (date of registration: 4 June 2019).
Highlights
Integration of palliative care concurrently to standard cancer care is associated with several benefits for patients and their caregivers
If the communication skills training proves to be effective, it will provide a feasible intervention to promote an earlier communication of palliative care related topics in the care of advanced cancer patients
Few communication skills trainings on palliative care related topics do exist, but those solely focus on communicating single, specific facets of palliative care [30, 33, 34]
Summary
Integration of palliative care concurrently to standard cancer care is associated with several benefits for patients and their caregivers. Multiple studies, including several randomized controlled trials, have shown the benefits of early implementation of palliative care concurrently to standard cancer care for patients and their caregivers. It is for example associated with improved symptom control, quality of life and mood, satisfaction with care, coping, understanding of disease and communication about care [3,4,5,6,7,8,9]. It has been shown that patients suffering from advanced cancer prefer an early talk about end-oflife topics [11,12,13,14]
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