A Telehealth Advance Care Planning Intervention for Older Patients With Acute Myeloid Leukemia and Myelodysplastic Syndrome

Not Applicable

Completed

Brief Summary: This is a pilot study to evaluate the usability and feasibility of a telehealth-delivered advance care planning intervention among 20 older patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).

Detailed Description: Older adults with AML and MDS are more likely to receive aggressive care and less likely to utilize hospice at the end-of-life. Advance care planning (ACP) intervention delivered through telehealth may improve patient-reported outcomes and end-of-life care in this population. This pilot study seeks to evaluate the usability and feasibility of a telehealth-delivered advance care planning intervention. We will adapt the Serious Illness Care Program.

Recruitment & Eligibility

Inclusion Criteria

Not provided

Exclusion Criteria

N/A

Inclusion Criteria for Caregivers

Age ≥21 years
Selected by patient when asked if there is a "family member, partner, friend, or caregiver with whom you discuss or who can be helpful in health-related matters"
Able to provide informed consent
English-speaking

Exclusion Criteria: N/A

Arm && Interventions

Group	Intervention	Description
Experimental	Telehealth	The SICG program consists of the Serious Illness Conversation Guide as well as training and system-level support for physicians to conduct ACP conversations.

Primary Outcome Measures

Name	Time	Method
Feasibility - Retention Rate	12 Weeks	Percentage of patients, caregivers, and clinicians who consented to the study, ultimately completing all study components
Recruitment Rate	12 Weeks	Number of patients, caregivers, and clinicians who are approached and agree to enroll.
Mean Usability of the Telehealth Advance Care Planning Intervention Using the Telehealth Usability Questionnaire (TUQ)	12 Weeks	Telehealth Usability Questionnaire (TUQ) - A questionnaire (22 questions scored from 1 to 7, a higher score indicates greater usability) assessing the usability of telehealth implementation across the population (for patients or caregivers), the mean of all questions is then calculated, range 1-7, with an average of greater than 5 considered usable.

Secondary Outcome Measures

Name	Time	Method
Pre- and Post-Intervention Change of the Mean Score for the General Anxiety Disorder-7 (GAD-7)	12 Weeks	General Anxiety Disorder-7 (GAD-7): A 7-item screening tool for anxiety (range 0-21, higher score indicates greater anxiety symptoms)
Pre- and Post-Intervention Change of the Mean Score for the Distress Thermometer	12 Weeks	Distress Thermometer: A self-reported tool to screen for symptoms of distress, using a 0-10 rating scale (higher score indicates greater distress level).
Pre- and Post-Intervention Change of the Mean Score for the Patient Health Questionnaire-9 (PHQ-9)	12 Weeks	Patient Health Questionnaire-9 (PHQ-9): A 9-item valid and reliable screening tool depression in the general population (range 0-27, higher score indicates greater depressive symptoms).
Post-Intervention Mean Score for the Health Care Communication Questionnaire (HCCQ)	12 weeks	Health Care Communication Questionnaire (HCCQ): A questionnaire assessing patients' satisfaction with patient-oncologist communication (12 items, range from 12-60), higher score indicates greater satisfaction with communication.
Pre- and Post-Intervention Change of the Mean Score for the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu)	12 Weeks	Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu): Consists of 17 questions on the general module and 17 leukemia-specific questions, score ranges from 0-176, higher score indicates better quality of life).