Friday, June 17, 20228:00 AM - 9:00 AM GPP01 Presentation Time: 8:00 AM: Prospective Randomized Clinical Trial of Patient Treatment-Related Anxiety Following the Use of a Gynecologic Brachytherapy-Specific Educational Video

Abstract

<h3>Purpose</h3> High dose rate brachytherapy is a highly technical and integral component of the definitive treatment of multiple gynecologic cancers. Gynecologic brachytherapy requires extensive treatment coordination, and patients associate high-quality care with the ability to participate in the decision-making process.Provider explanation of treatment complexities can be overwhelming despite in-depth discussion leading up to informed consent. This study sought to engage and educate the patient regarding the expected treatment trajectory using audiovisual mixed multimedia that comprehensively discusses the entire brachytherapy procedural process. We report on the utilization of this educational video and the effect on patient treatment-related anxiety. <h3>Materials and Methods</h3> This prospective, randomized, clinical trial included patients receiving treatment with gynecologic high dose rate brachytherapy. Patients were randomly assigned to the standard clinic consultation/ education (group A) or enhanced video education intervention arm (group B) using 1:1 block randomization. All patients met with the treating radiation oncologist and had the standard of care procedure consent performed. Patients in the intervention arm had access to view the brachytherapy educational video (https://vimeo.com/403385455/d0716e3cc8https://vimeo.com/403385455/d0716e3cc8) prior to the brachytherapy procedure. Patients' friends and family members were also provided access to the video. A previously validated, modified NCCN Distress Tool including a distress score and symptom survey to assess patient treatment-related anxiety as well as a treatment-specific patient reported satisfaction survey were collected from each patient at 3 timepoints: baseline, before the brachytherapy procedure, and after the brachytherapy procedure. <h3>Results</h3> Between 2/10/2020 and 1/28/2022, 80 patients with gynecologic cancer were enrolled and randomized to receive the standard of care consent process alone (n=40, group A) or online access to the gynecologic brachytherapy patient education video in addition to the standard of care consent process (n=40, group B). Of the 40 patients enrolled in the video intervention arm, 19 patients (48%) viewed the video - 14 of the 19 (74%) patients watched the video to completion, and 17 of 19 (89%) watched greater than 50% of the video. Patients' friends and family were less likely to view the video, with 10/40 (25%) friends and family viewing the video at all, and only 4 of these 10 completed the video. The mean (±SD) distress scores (scaled from 0 to 10, with 0 being "no distress or anxiety") were 4.31 (±3.26) vs 3.93 (±3.11) at baseline, 4.59 (±3.01) vs 4.63 (±2.72) prior to brachytherapy, and 3.90 (±3.58) vs 3.22 (±2.94) after brachytherapy for group A and group B, respectively. The mean (±SD) scores for the symptom survey, composed of 13 mental and physical symptoms scaled from 0 ("none at all") to 5 ("very much,") were 32.41 (±12.45) vs 30.78 (±13.17) at baseline, 29.90 (±14.26) vs 26.44 (±12.90) prior to brachytherapy, and 31.10 (±18.33) vs 26.67 (±16.24) after brachytherapy for group A and group B, respectively. There was no statistically significant difference in distress scores or symptom survey scores between groups. <h3>Conclusions</h3> This is the first prospective trial investigating the use of an educational video intervention in gynecologic brachytherapy to better understand the impact of this tool on patient distress and symptom scores. We did not see a difference in patient-reported treatment-related anxiety for patients given access to the video. However, less than 50% of the patients assigned to the video arm attempted to view the video and less than 25% of patients' friends and family access the video. Of note, patients in both arms had relatively low distress and symptom survey scores at all three timepoints in our study. Further work is needed to understand the factors contributing to treatment-related anxiety and how to create and implement strategies to improve this experience for patients.