Pilot Randomized Trial of an Educational Intervention About Immunotherapy for Patients With Advanced Cancer and Their Caregivers
Background
Immune checkpoint inhibitors (ICIs) are common cancer treatments. We created a program called UPLIFT, which includes a video and a list of questions to help educate patients about the risks and benefits of ICIs.
Patients and Methods
We conducted a trial with 130 adults starting ICIs and their caregivers. Participants were randomly assigned to either receive UPLIFT or standard care before starting treatment. They completed surveys at the beginning, 72 hours later, and 6 weeks after starting ICIs. We focused on:
- Feasibility: We aimed for at least 70% enrollment and 80% of UPLIFT patients to watch the video and use the question list.
- Knowledge: We tested their understanding of ICIs with 8 questions.
- Acceptability: We measured how well patients liked UPLIFT.
- Anxiety: We assessed anxiety levels using a specific inventory.
- Patient Activation: We counted how many questions patients asked during their oncology visits.
Results
We enrolled 130 out of 178 eligible patients (73%) and 56 caregivers. The average age of patients was 67 years, with many having melanoma (41%) or lung cancer (26%). All UPLIFT patients (100%) watched the video, and 47% used the question list. Most patients (94%) felt comfortable using UPLIFT. Knowledge about ICIs improved for UPLIFT patients compared to the control group after 72 hours. However, there was no significant change in anxiety levels or knowledge after 6 weeks. UPLIFT patients asked more questions during their visits.
Conclusions
The UPLIFT educational program was easy to implement, well-received, and helped improve patient knowledge and engagement without increasing anxiety. Further studies are needed to evaluate its effectiveness on other outcomes, including severe side effects from ICIs.
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