Evaluation of Cross-Disciplinary Educational Material to Improve Patients’ Knowledge and Utilization of Palliative Radiation Therapy

Abstract

<h3>Purpose/Objective(s)</h3> Palliative radiation therapy (PRT) is underutilized in the United States, in part due to misconceptions among patients and other providers about its risks, benefits, and indications. Empowered patients, who are more knowledgeable about how radiation can alleviate cancer-induced symptoms, may facilitate more appropriate and timely use of PRT. In this pilot study patient-directed educational material describing PRT was developed and used among patients being treated in medical oncology and palliative care clinics. The hypothesis is that most patients will gain new knowledge from educational content about PRT, and perceive it as useful in their care. <h3>Materials/Methods</h3> A 1-page educational handout was developed to convey general information about the purpose, logistics, benefits, risks, and common indications for PRT. Patients undergoing treatment for a metastatic solid tumor were invited to participate during their regular clinic visit. Patients who chose to participate read the handout, and then completed a multiple-choice questionnaire assessing how much they learned from the handout (nothing vs. little vs. lots), whether the information in the handout was useful (no vs. somewhat vs. very), as well as other questions. Responses were anonymous. There was no follow-up with participants. Descriptive statistics are reported, with Fisher's Exact Test used to compare subgroups of patients. <h3>Results</h3> A total of 70 patients from 1 palliative care physician and 4 medical oncologists participated between June – December 2021. Sixty-five patients (89%) felt they learned from the handout (38% learned "lots") and 69 (94.5%) felt the information was useful (53% "very useful"). Twenty-one patients (28.8%) learned that PRT can help with symptom relief, 55 (75%) learned that PRT can be delivered in a course of 5 treatments or less, and 43 patients (59%) learned that PRT usually has few side effects. Furthermore, 16 (22%) felt they currently had symptoms not being treated well enough, and 34 (47%) felt they currently had symptoms that radiation might help with. Most patients felt more comfortable bringing symptoms to a medical oncologist's (n = 57, 78%) or radiation oncologist's (n = 51, 70%) attention after reading the handout. Forty-one patients (56.2%) reported a prior visit with a radiation oncologist, but this did not impact their responses related to learning from the handout (<i>p</i><0.001) or finding the handout useful (<i>p</i><0.001). <h3>Conclusion</h3> Patient-directed educational material about PRT provided outside of a radiation oncology department was perceived by patients as improving their knowledge, and adding value in their care, independent of their prior exposure to a radiation oncologist. Further research will evaluate the impact of the educational material on referral patterns.