Abstract 1608P
Background
There are unique challenges in oncology care delivery in India & other Low- and Middle- Income countries (LMICs). The BBN session profoundly affects patient experience & can do lasting damage if done improperly. PENS protocol [Patient(pt) preference elicitation, Explanation, scheduling the Next appointment & offering Support] is an abbreviated protocol based on ethical principles, suitable for BBN in crowded outpatient (OP) setting. We conducted this study to assess the feasibility of this approach in an oncology OP.
Methods
This was an observational study including pts with newly diagnosed cancer or cancer progression who were unaware of their condition & were willing to have a discussion regarding their disease status. The duration for BBN was the primary outcome, measured from the start of the conversation regarding the disease, not inclusive of history taking, examination, report review & financial discussions (in some cases). After BBN, study pts filled a six-item validated questionnaire (based on Likert method). Pts with sum of the response scores of <13 were classified as being content with the BBN session. The oncologists’ comfort was also assessed with a questionnaire.
Results
Of the 130 screened pts, 50 pts were included. The mean age was 53.7 years & majority (78%) of the pts had only primary school education. The average time taken for the BBN session was 6.1 (range 2-11) minutes. Assessed by the response score sum, 43(86%) pts were satisfied with BBN. Only three (6%) of the discontented pts felt that the BBN session was too short. Most (94%) pts felt that enough information was imparted for them to make a treatment decision or they had only a few doubts. After the session,36 (72%) pts admitted to either feeling the same or reassured when compared to before the session. The oncologists were comfortable with the protocol.
Conclusions
There is an unmet need for validated communication protocols in LMIC for difficult communication sessions. The PENS approach is practical & suitable for patients in our practice setting, where oncologists have a high patient load. Both the pts & the oncologists were satisfied with this abbreviated protocol, appropriate for the real-world OP setting. Future trials are required to validate the protocol in other settings.
Clinical trial identification
CTRI/2021/07/034707.
Editorial acknowledgement
Legal entity responsible for the study
Sharada Mailankody.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.