%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 8
%N 
%P e58503
%T Clinicians’ Perspectives on the Telehealth Serious Illness Care Program for Older Adults With Myeloid Malignancies: Single-Arm Pilot Study
%A LoCastro,Marissa
%A Wang,Ying
%A Yu,Tristan
%A Mortaz-Hedjri,Soroush
%A Mendler,Jason
%A Norton,Sally
%A Bernacki,Rachelle
%A Carroll,Thomas
%A Klepin,Heidi
%A Wedow,Lucy
%A Goonan,Sean
%A Erdos,Hannah
%A Bagnato,Brenda
%A Liesveld,Jane
%A Huselton,Eric
%A Kluger,Benzi
%A Loh,Kah Poh
%+ Division of Hematology Oncology, Department of Medicine, James P. Wilmot Cancer Institute, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, United States, 1 585 276 4353, Kahpoh_Loh@urmc.rochester.edu
%K serious illness conversations
%K serious illness conversation
%K SIC
%K Serious Illness Care Program
%K SICP
%K hematologic malignancy
%K geriatric oncology
%K acute myeloid leukemia
%K AML
%K myelodysplastic syndrome
%K MDS
%K cancer
%K oncology
%K oncologist
%K oncologists
%K metastases
%K telemedicine
%K telehealth
%K tele-medicine
%K tele-health
%D 2024
%7 27.6.2024
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Serious illness conversations may help patients avoid unwanted treatments. We previously piloted the telehealth Serious Illness Care Program (SICP) for older adults with acute myeloid leukemia and myelodysplastic syndrome. Objective: In this study, we aimed to understand the experience of the telehealth SICP from the clinician’s perspective. Methods: We studied 10 clinicians who delivered the telehealth SICP to 20 older adults with acute myeloid leukemia or myelodysplastic syndrome. Quantitative outcomes included confidence and acceptability. Confidence was measured using a 22-item survey (range 1-7; a higher score is better). Acceptability was measured using an 11-item survey (5-point Likert scale). Hypothesis testing was performed at α=.10 (2-tailed) due to the pilot nature and small sample size. Clinicians participated in audio-recorded qualitative interviews at the end of the study to discuss their experience. Results: A total of 8 clinicians completed the confidence measure and 7 clinicians completed the acceptability measure. We found a statistically significant increase in overall confidence (mean increase of 0.5, SD 0.6; P=.03). The largest increase in confidence was in helping families with reconciliation and goodbye (mean 1.4, SD 1.5; P=.04). The majority of clinicians agreed that the format was simple (6/7, 86%) and easy to use (6/7, 86%). Clinicians felt that the telehealth SICP was effective in understanding their patients’ values about end-of-life care (7/7, 100%). A total of three qualitative themes emerged: (1) the telehealth SICP deepened relationships and renewed trust; (2) each telehealth SICP visit felt unique and personal in a positive way; and (3) uninterrupted, unrushed time optimized the visit experience. Conclusions: The telehealth SICP increased confidence in having serious illness conversations while deepening patient-clinician relationships. Trial Registration: ClinicalTrials.gov NCT04745676; https://www.clinicaltrials.gov/study/NCT04745676 
%M 38935428
%R 10.2196/58503
%U https://formative.jmir.org/2024/1/e58503
%U https://doi.org/10.2196/58503
%U http://www.ncbi.nlm.nih.gov/pubmed/38935428