Observational studyBMC palliative care2020
Implementation of the milestones communication approach for patients with limited prognosis: evaluation of intervention fidelity.
Observational study in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Dignity therapy intervention fidelity: a cross-sectional descriptive study with older adult outpatients with cancer.BMC palliative care · 2022Trial
- Effects of an Interprofessional Communication Approach on Support Needs, Quality of Life, and Mood of Patients with Advanced Lung Cancer: A Randomized Trial.The oncologist · 2021Trial
- Two Languages and One Aphasia: A Systematic Scoping Review of Primary Progressive Aphasia in Chinese Bilingual Speakers, and Implications for Diagnosis and Clinical Care.Brain sciences · 2025Review
- Illness trajectories of incurable solid cancers.BMJ (Clinical research ed.) · 2024Article
- Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Article
- Supportive care interventions and quality of life in advanced disease prostate cancer survivors: An integrative review of the literature.Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundDespite improvements in diagnostics and therapy, the majority of lung tumours are diagnosed at advanced stage IV with a poor prognosis. Due to the nature of an incurable disease, patients need to engage in shared decision making on advance care planning. To implement this in clinical practice, effective communication between patients, caregivers and healthcare professionals is essential. The Heidelberg Milestones Communication Approach (MCA) is delivered by a specifically trained interprofessional tandem and consists of four milestone conversations (MCs) at pivotal times in the disease trajectory. MC 1 (Diagnosis): i.e. prognosis; MC 2 (Stable disease): i.e. prognostic awareness; MC 3 (Progression): i.e. reassessment; MC 4 (Best supportive care): i.e. end of treatment. In between MCs, follow-up calls are carried out to sustain communication. This study aimed to assess to what extent the MCA was implemented as planned and consolidated in specialized oncology practice.
methodsA prospective observational process evaluation study was conducted, which focused on the implementation fidelity of the MCA. All MCs during two assessment periods were included. We analysed all written records of the conversations, which are part of the routine documentation during MCs and follow-up calls. Adherence to key aspects of the manual was documented on structured checklists at the beginning of the implementation of the MCA and after 6 months. The analysis was descriptive. Differences between the two assessment periods are analysed with chi-square tests.
resultsA total of 133 MCs and 54 follow-up-calls (t1) and of 172 MCs and 92 follow-up calls (t2) were analysed. MC 2 were the most frequently completed conversations (n = 51 and n = 47). Advance care planning was discussed in 26 and 13% of MC 2 in the respective assessment periods; in 31 and 47% of MC 2, prognostic awareness was recorded. The most frequently documented topic in the follow-up calls was the physical condition in patients (82 and 83%).
conclusionThe implementation of a trajectory-specific communication concept was largely successful. Additional studies are needed to understand how fidelity could be further improved.
trial registrationDRKS00013469 / Date of registration: 22.12.2017.
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