Mindfully Optimizing Delivery of End-of-Life Care

Mindfully Optimizing Delivery of End-of-Life Care (MODEL Care): Feasibility of a Synergistic Intervention for Patients, Family Caregivers, and Providers

The study evaluates the feasibility, acceptability, and preliminary efficacy of a mindfulness meditation-based intervention designed to provide a synergistic solution to the avoidant coping that often inhibits advance care planning discussions that are crucial to quality end-of-life care.

Inclusion Criteria:

Oncologists:

• Be a physician specializing in medical oncology
• Care for oncology patients at the affiliated cancer center
• Have a patient panel that will allow for ≥6 eligible patients to be enrolled in the study
• Be willing to attend the 5-session MODEL Care program for providers at the specified location, date, and time

Patients:

• Adults ≥ 18 years of age
• Receiving care from a medical oncologist enrolled in the study
• Diagnosed with an incurable and advanced-stage solid malignancy (late stage III [B or C] or stage IV)
• Have an attending medical oncologist who would not be surprised if the patient died in the next 12 months
• Willing and able to travel to the class location for 6 weekly 2-hour sessions
• Have a family member or friend eligible and interested in participating in the MODEL Care study
• Able and willing to provide informed consent
• Not have completed a Physician Orders for Scope of Treatment (POST) form

Family Caregivers:

• Adults ≥18 years of age
• Chosen by a family member or friend with cancer to join them in participating in the MODEL Care study
• Willing and able to travel to the class location for 6 weekly 2-hour sessions
• Able and willing to consent.

Exclusion Criteria:

Oncologists:

• Planning to leave current practice setting for other employment in the next 3 months.

Patients:

• Eastern Cooperative Oncology Group (ECOG) performance status of >2 or Karnofsky performance status <60 (suggesting patient is capable of only limited self-care, confined to bed or chair more than 50% of waking hours, or requires considerable assistance and frequent medical care) as rated by the attending oncologist
• Currently receiving hospice care.