Individuals undergoing stem cell transplantation for cancer treatment represent a patient population that faces complex medical decision-making needs. This population typically has high symptom burden, diminished quality of life, and often receives resource-intensive care at the end of life as well. In addition, this group traditionally has low rates of completion of advance directives regarding preferences for end of life care. In a two-phase randomized trial of patients undergoing stem cell transplantation within the University of Pennsylvania Health System, we will examine the effect of a pre-transplantation educational advanced care planning intervention on patients’ self-reported decisional conflict prior to transplant. We will also assess patients' quality of life and therapeutic alliance,the perceived bond or relationship with their oncologists two months post-transplant. Patients who experience complications from their transplant will be randomized to receive usual care or a triggered palliative care consultation. Our evaluation of this intervention will focus on health resource utilization at the end of life.
American Cancer Society Institutional Research Grant