Lyon, M.E., Jacobs, S., Briggs, L., Cheng, Y., Iris, & Wang, J. (2014). A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: Anxiety, depression, quality of life, advance directives, spirituality. Journal of Adolescent Health, 54, 710–717.
To test the feasibility, acceptability, and impact of family-centered advanced care planning for adolescents with cancer
Adolescent/family dyads were randomized to intervention and control study arms. All participants received a baseline assessment and were provided with an advanced care planning educational brochure. Those in the intervention group had five sessions of assessments and interviews and three weekly sessions with a trained or certified facilitator to explore values and beliefs, have conversations, share decision making processes about palliative care and goals, and express fears, values, beliefs, and goals about death and dying. Study measures were obtained at baseline and at three months.
Randomized, controlled trial
Anxiety declined in all adolescents over time. Among families, anxiety declined in those in the control group but increased in families in the intervention group. Baseline depression was significantly lower in the intervention group and increased over time. There were no significant differences between groups from the group and time analysis. There were no significant differences between groups in quality of life results. There were no other differences based on group assignment.
The family-centered advance care planning intervention tested here did not demonstrate any benefits for patients or families in regard to anxiety, depression, or quality of life.
Advance care planning is an important component of care for patients with cancer and their families. However, it might not reduce the emotional effects of the cancer trajectory. This study had numerous limitations and did not find benefit in terms of reducing anxiety or depression. Additional well-designed studies are needed to confirm the findings shown here.