Adapting an Advance Care Planning Intervention Delivered via Telehealth for Older Patients With Acute Myeloid Leukemia and Myelodysplastic Syndromes

Background Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) experience high-intensity care (eg, chemotherapy, hospitalization, life-sustaining treatments) during the end of life. Early advance planning (ACP) may promote end-of-life that is more consistent patients’ values goals. As COVID-19 pandemic has resulted in a rapid shift to telehealth, use such methods improve access ACP among this vulnerable population. Objective In qualitative study, we aimed adapt an evidence-based intervention, Serious Illness Care Program (SICP), be delivered via telehealth for older adults AML MDS. Methods We conducted semistructured interviews 14 oncology clinicians 10 palliative (physicians, advanced practitioners, nurses), as well 15 4 caregivers. Oncology were recruited if they had cared at least one patient or MDS past year. Eligible aged ≥60 years diagnosis MDS, their caregivers, available, recruited. Interviews transcribed qualitatively coded by 2 independent coders using MAXQDA (VERBI GmbH). used directed content analyses focused on delivery (telehealth vs in-person ACP) SICP. Results The mean ages clinicians, patients, caregivers 48, 71, 66 years, respectively. Health literacy, which was measured 6-item Cancer Literacy Test, high both (score: 6; range 0-6) 6). majority participants liked intent SICP, suggestions mainly wording changes. One stated, “I wish I’d little back beginning, it would’ve eased my way through….” Oncologists expressed positive feedback SICP language “planting seeds” conversation, emphasizing “it doesn’t it’s going happen.” comfortable conducting discussions telehealth. Providers felt conversations would allow them “deliver less burden.” Most however “after first couple appointments [being] in-person” establish care. Lastly, providers including geriatric assessment summary prior “helps ground anchor discussion,” provides “sense baseline functionality…[and] quality life.” Conclusions Overall, received This stakeholder will help us better understand current barriers gauge whether utilized ACP. further refine intervention future single-arm pilot study. Trial Registration ClinicalTrials.gov NCT04745676; https://clinicaltrials.gov/ct2/show/NCT04745676 Acknowledgements Funding: R00CA237744, 5UG1CA189961, R33AG059206. Conflicts Interest None declared.