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Educational Video About Hospice Linked to Higher Utilization Rate, Longer Hospice Stay

Key findings

  • Oncologists at the Massachusetts General Hospital Cancer Center created a six-minute video for patients and caregivers that describes the role of hospice, who benefits, the appropriate time to enroll and how services are covered financially
  • In this randomized trial, 150 patients with advanced cancer and 44 caregivers were assigned to either watch the video or hear its narrative read aloud (control group)
  • Post-intervention, patients and their caregivers who viewed the video were found to be more informed about hospice care than controls and to have more positive perceptions of hospice
  • Among participants who died during the study period, the video was associated with increases in hospice use and hospice length of stay

In the U.S., only 40% to 50% of patients with advanced cancer die under hospice care, and about one-third use hospice for less than a week.

To help individuals imagine what hospice care is like, Jennifer S. Temel, MD, clinical director of Thoracic Oncology, and Areej El-Jawahri, MD, hematologist, both from the Massachusetts General Hospital Cancer Center, and colleagues created an educational video. In a randomized, controlled trial reported in Cancer, the video improved knowledge and perceptions of hospice and enhanced patients' hospice use and length of stay.

Study Details

Between February 2017 and January 2019, the team enrolled 150 hospitalized adult patients with advanced cancer who had life expectancy ≤12 months. Forty-four caregivers also participated.

Patients and caregivers were randomly assigned to view a six-minute video or have the video narrative read to them. The video described the role of hospice, who benefits, the appropriate time to enroll and how services are covered financially. It included comments from patients, caregivers, palliative care clinicians, oncologists and hospice providers.

Post-intervention Results: Patients

  • Preference for hospice care at end of life—87% of video group vs. 83% of control group (P = NS)
  • Score on test of 10 knowledge items—9.0 vs. 8.4 (P = .049)
  • Endorsed the statement "Hospice care is only about death"—7% vs. 22% (P = .01)
  • "Hospice care is giving up"—16% vs. 18% (P = NS)

Post-intervention Results: Caregivers

  • Preference for loved one to have hospice care—94% of video group vs. 65% of control group (P = .03)
  • Knowledge— 9.7 vs. 8.0 (P = .001)
  • "Only about death"—0% vs. 27% (P = .03)
  • "Giving up"— 0% vs. 27% (P = .03)

Hospice Use

77% of patients died during the study period. Within that subgroup, those who viewed the video were more likely than controls to have used hospice (85% vs. 64%; P = .01), and they had a longer hospice stay (median, 12 vs. 3 days; P < .001).

Learn more about the Mass General Cancer Center

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