SERENITY: Towards Cancer Patient Empowerment for Optimal Use of Antithrombotic Therapy at the End of Life

Short description

The development and evaluation of a shared decision tool, aimed to support patients, their companions and healthcare professionals make evidence based and informed decisions about prescription of antithrombotic medication near the end of life.

Background

Advanced care planning for patients with terminal and life limiting illness has become the standard of care across many European countries. A component of this is a process of what is known as rationalisation of medicines, which includes deprescribing of medicines that are no longer necessary and/or are potentially harmful.

The decision of whether to continue antithrombotic therapies, such as anticoagulants or antiplatelet medicines in cancer patients at the end of life is particularly complex and unclear due to lack of evidence, hence is the focus of this study.

Aims

To develop and evaluate a shared decision tool to support patients, their companions and healthcare professionals make evidence based and informed decisions about antithrombotic medicines near the end of life.

Methods

The development and evaluation of the shared decision tool will be achieved across 8 countries and 14 research institutions across the UK and Europe. The study consists of the following work packages (WP):

• a realist literature review (WP1)
• a ‘flash mob’ audit of current practice (WP1)
• epidemiological database analysis of current practice (in 3 countries) (WP2)
• qualitative interviews with patients, their companions, and clinical stakeholders (WP3)
• a Delphi exercise to inform the content and design of the shared decision tool (in the form of an app) (WP4)
• development of the shared decision-making tool to be used as an app (WP5)
• evaluation of the tool against standard practice (WP6)

A European public involvement strategy aligned with the study, is also in place across work packages in SERENITY and led from the Marie Curie Research Centre here at Cardiff University. The impact of public involvement in SERENITY has and will continue to be planned out and tracked using the recently developed Public Involvement in Research Impact Toolkit (PIRIT).

More information can be found on the SERENITY website.

Progress

Work packages 1-3 are currently in progress. These work packages will feed into subsequent work packages. Work package 5 is also in progress.

Impact

This study is currently ongoing. SERENITY is an international collaboration, aiming to answer an important and highly relevant research question that is currently an area of clinical uncertainty and will become an even greater challenge over the coming years.

Information