School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, United States.
Cancer Med. 2023 Apr;12(7):8581-8593. doi: 10.1002/cam4.5547. Epub 2022 Dec 19.
In a single-arm pilot study, we assessed the feasibility and usefulness of an innovative patient-centered communication tool (UR-GOAL tool) that addresses aging-related vulnerabilities, patient values, and prognostic awareness for use in treatment decision making between older adults with newly diagnosed acute myeloid leukemia (AML), their caregivers, and oncologists.
Primary feasibility metric was retention rate; >50% was considered feasible. We collected recruitment rate, usefulness, and outcomes including AML knowledge (range 0-14) and perceived efficacy in communicating with oncologists (range 5-25). Due to the pilot nature and small sample size, hypothesis testing was performed at α = 0.10.
We included 15 patients (mean age 76 years, range 64-88), 12 caregivers, and 5 oncologists; enrollment and retention rates for patients were 84% and 73%, respectively. Patients agreed that the UR-GOAL tool helped them understand their AML diagnosis and treatment options, communicate with their oncologist, and make more informed decisions. From baseline to post-intervention, patients and caregivers scored numerically higher on AML knowledge (patients: +0.6, p = 0.22; caregivers: +1.1, p = 0.05) and perceived greater efficacy in communicating with their oncologists (patients: +1.5, p = 0.22; caregivers: +1.2, p = 0.06).
We demonstrated that it is feasible to incorporate the UR-GOAL tool into treatment decision making for older patients with AML, their caregivers, and oncologists.
在一项单臂试点研究中，我们评估了一种创新的以患者为中心的沟通工具（UR-GOAL 工具）的可行性和实用性，该工具针对与老年人新诊断的急性髓系白血病（AML）相关的脆弱性、患者价值观和预后意识，用于老年 AML 患者、其照顾者和肿瘤医生之间的治疗决策。
主要的可行性指标是保留率；>50%被认为是可行的。我们收集了招募率、有用性和结果，包括 AML 知识（范围 0-14）和与肿瘤医生沟通的感知效果（范围 5-25）。由于试点性质和样本量小，假设检验在 α=0.10 时进行。
我们纳入了 15 名患者（平均年龄 76 岁，范围 64-88 岁）、12 名照顾者和 5 名肿瘤医生；患者的入组和保留率分别为 84%和 73%。患者认为 UR-GOAL 工具帮助他们了解了 AML 诊断和治疗选择，与肿瘤医生进行了沟通，并做出了更明智的决策。与基线相比，患者和照顾者在 AML 知识方面的评分（患者：+0.6，p=0.22；照顾者：+1.1，p=0.05）和与肿瘤医生沟通的感知效果（患者：+1.5，p=0.22；照顾者：+1.2，p=0.06）均有所提高。
我们证明了将 UR-GOAL 工具纳入老年 AML 患者、其照顾者和肿瘤医生的治疗决策是可行的。
