TY  - JOUR
AU  - LoCastro, Marissa
AU  - Wang, Ying
AU  - Yu, Tristan
AU  - Mortaz-Hedjri, Soroush
AU  - Mendler, Jason
AU  - Norton, Sally
AU  - Bernacki, Rachelle
AU  - Carroll, Thomas
AU  - Klepin, Heidi
AU  - Wedow, Lucy
AU  - Goonan, Sean
AU  - Erdos, Hannah
AU  - Bagnato, Brenda
AU  - Liesveld, Jane
AU  - Huselton, Eric
AU  - Kluger, Benzi
AU  - Loh, Kah Poh
PY  - 2024
DA  - 2024/6/27
TI  - Clinicians’ Perspectives on the Telehealth Serious Illness Care Program for Older Adults With Myeloid Malignancies: Single-Arm Pilot Study
JO  - JMIR Form Res
SP  - e58503
VL  - 8
KW  - serious illness conversations
KW  - serious illness conversation
KW  - SIC
KW  - Serious Illness Care Program
KW  - SICP
KW  - hematologic malignancy
KW  - geriatric oncology
KW  - acute myeloid leukemia
KW  - AML
KW  - myelodysplastic syndrome
KW  - MDS
KW  - cancer
KW  - oncology
KW  - oncologist
KW  - oncologists
KW  - metastases
KW  - telemedicine
KW  - telehealth
KW  - tele-medicine
KW  - tele-health
AB  - 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 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e58503
UR  - https://doi.org/10.2196/58503
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38935428
DO  - 10.2196/58503
ID  - info:doi/10.2196/58503
ER  -