Patient-, Clinician-Directed Nudges Increase Rates of Serious Illness Conversations in Oncology Setting

THURSDAY, June 18, 2026 (HealthDay News) -- For patients at disease-based oncology clinics about to start a treatment associated with poor prognosis, combined clinician- and patient-directed nudges result in higher rates of serious illness conversations (SICs), aimed to elicit patient preferences, according to a study published online June 16 in the Journal of the National Comprehensive Cancer Network.Christopher R. Manz, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues conducted a trial involving adult patients at five disease-based oncology clinics with pathways data indicating that they were starting a treatment associated with a poor prognosis without documentation of an SIC in the Advance Care Planning module of the electronic health record (ACP-SICs) in the preceding six months. Participants were randomly assigned to a nudge encouraging SICs (patient-nudge); a clinician nudge to prompt an SIC (clinician-nudge); both nudges (combined-nudge); or no nudges (277, 240, 273, and 261 patients, respectively).The researchers found that for the no-nudge (control), clinician-nudge, patient-nudge, and combined-nudge arms, the ACP-SIC rates were 10.7, 16.7, 10.6, and 17.3 percent, respectively. The prespecified alternative outcomes including SICs identified in the free text of clinician notes using natural language processing rates were 22.6, 28.8, 22.3, and 32.5 percent, respectively. Significantly higher rates were seen for patients in the combined-nudge group versus the control group."When a patient is prepared to have these conversations through initial outreach and walks into the office already thinking about what matters most to them, the clinician has a more receptive partner across the desk, and the conversation is easier to start and goes deeper," co-lead author Cody E. Cotner, M.D., from Harvard Medical School in Boston, said in a statement.Abstract/Full Text.Sign up for our weekly HealthDay newsletter

Patient-, Clinician-Directed Nudges Increase Rates of Serious Illness Conversations in Oncology Setting

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