Telephone-Based Coaching Sessions (TAC) to Improve Advance Care Planning Participation in Advanced Cancer Patients and Their Caregivers

Fred Hutchinson Cancer Center (FHCC)

Status: Begins enrollment in 1 month

Conditions: Advanced Malignant Solid Neoplasm; Hematopoietic and Lymphatic System Neoplasm

Treatments: Behavioral: Telephone-Based Intervention; Other: Survey Administration; Other: Supportive Care; Other: Educational Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT07141407

FHIRB0020936 (Other Identifier)

RG1125666

NCI-2025-05520 (Registry Identifier)

Details and patient eligibility

About

This clinical trial studies whether telephone-based coaching sessions, Talking About Cancer (TAC), work to improve engagement in advance care planning (ACP) in patients with cancer that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced) and their caregivers. Participation in ACP, which includes having end of life (EOL) care conversations and completing advance directives (e.g., living will, health care proxy, do not resuscitate order), improves quality EOL care. Despite this, less than half of patients with advanced cancer have EOL care conversations or complete advance directives. TAC coaching sessions are delivered by a social worker over the phone. They are designed to help patients and their caregivers communicate about ACP, manage the distress these conversations can cause, and participate in the process of ACP with a clear action plan of having goals-of-care conversations and completing advance directives. This may be an effective way to improve ACP participation in advanced cancer patients and their caregivers.

Full description

OUTLINE: Participants are randomized to 1 of 2 arms.

ARM I: Participants attend Talking About Cancer (TAC) telephone-based coaching sessions (2 sessions) designed to support participants in communicating about advance care planning (ACP), managing distress around ACP conversations, engaging in the process of ACP, and completing advance directives over 45-60 minutes each once a week (QW) for 2 weeks.

ARM II: Participants receive an ACP brochure/handout on study.

After completion of study intervention, participants are followed up at 6- and 12-weeks post-randomization.

Enrollment: 80 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• PATIENT: Current diagnosis of stage III or IV cancer
• PATIENT: Able to provide informed consent
• PATIENT: Fluent in English or Spanish
• PATIENT: Have access to a telephone or computer with internet access
• CAREGIVER: Person patient indicates provides support
• CAREGIVER: English or Spanish speaking
• CAREGIVER: 18 years of age or older
• CAREGIVER: Able to provide informed consent

Exclusion criteria

• PATIENT: Too ill or weak to complete the interviews (as judged by the interviewer)
• PATIENT: Receiving hospice at the time of enrollment
• PATIENT: Younger than age 18

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

Arm I (TAC sessions)

Experimental group

Description:

Participants attend Talking About Cancer (TAC) telephone-based coaching sessions (2 sessions) designed to support participants in communicating about advance care planning (ACP), managing distress around ACP conversations, engaging in the process of ACP, and completing advance directives over 45-60 minutes each once a week (QW) for 2 weeks.

Treatment:

Other: Supportive Care

Other: Survey Administration

Behavioral: Telephone-Based Intervention

Arm II (enhanced usual care)

Active Comparator group

Description:

Participants receive an ACP brochure/handout on study.

Treatment:

Other: Educational Intervention

Other: Survey Administration