SCOPED question-listing improves distress, anxiety, and question self-efficacy among hematological cancer patients and may enhance provider-patient dialogue and access to clinical trials

Background: The Open to Options pilot project provides one-on-one decision support to hematological cancer patients in 3 sites nationwide. Methods: Facilitators provide support using an evidence-based decision-making model SCOPED (Situation-Choices-Objectives-People-Evaluation-Decisions) to prompt patients to list questions about diagnosis and treatment, including the option of a cancer clinical trial (CCT). Patients complete pre- and post-session surveys, and at 30 and 90 days. Distress, anxiety and question self-efficacy are measured using a 10-point scale. For a subset, outcomes include use of the question list during their oncology visit. Results: Three facilitators have used the SCOPED question-listing process with 69 patients (14% ethnic minority). Among patients, there was a decrease in distress (p=0.065) and anxiety (p=0.008) and increase in question self-efficacy (p<0.001). Nearly half (51%) reported discussing CCTs with their oncologist. Currently, 44 have made a treatment decision, and 4 (9%) of these chose treatment through a CCT. At 30 days, 28 of 35 patients (80%) reported bringing their question list to their oncology appointment. Among those who brought their question list (n=28), 93% referred to it, 33% showed it to their oncologist, 86% thought the question list contributed to a more productive appointment, and 86% reported their oncologist answered most of their questions. Participants reported the question list: “gave structure to the meeting like an agenda”; “clarified my thoughts”; and “was empowering.” Conclusion: Early findings suggest use of SCOPED question-listing for blood cancer patients may improve coping and decision-making skills and may lead to enhanced patient dialogue and access to clinical trials.