New Study: Reducing patient depression & anxiety through more, better and earlier conversations

Adults diagnosed with a serious advancing illness may experience considerable stress, resulting not only from living with a serious illness but from the complexities of making personal and medical decisions. The Honoring Choices Partners, who routinely engage adults in care planning conversations, experience first-hand the power of conversations to ease stress, build trust, and help adults make a care plan that aligns with their priorities, values and care choices.

The Serious Illness Program at Ariadne Labs provides innovative communication tools including a guide for clinicians who wish to start early conversations and to build on those conversations for effective care planning and person directed care.

Now a new study shows that early and on-going conversations can also significantly reduce the symptoms of depression and anxiety. “We know how beneficial patient-centered conversations are, and our goal is to ensure that they happen for all patients, earlier in the course of illness and focus on what matters most to the patients,” said Dr. Rachelle Bernacki, Associate Director of the Serious Illness Care Program, Ariadne Labs, and a palliative care doctor at Dana-Farber Cancer Institute.

This 4 year study demonstrates the extent to which the Serious Illness Program, developed by Ariadne Labs and tested at the Dana-Farber Cancer Institute, resulted in more, earlier and better serious illness conversations between patients and their oncology clinicians, and led to significant reductions in emotional suffering for patients with advanced cancer. On average, patients and clinicians had a serious illness conversation 2.4 months earlier  -- almost five months before death. These conversations were focused on what matters most to patients, with 90 percent of patients discussing goals and values. As a result of the intervention, the proportion of patients with moderate to severe anxiety and depression was reduced by half, and the anxiety improvements were sustained for at least 24 weeks.

“These results are exciting because they show us that more, better and earlier conversations are possible and they can reduce symptoms of depression and anxiety in our most vulnerable patients,” says Dr. Bernacki.

The complete findings were published in two papers, one in JAMA Internal Medicine and the other in JAMA Oncology on March 14.

• “Evaluating an Intervention to Improve Communication Between Oncology Clinicians and Patients With Life-Limiting Cancer: A Cluster-Randomized Clinical Trial of the Serious Illness Care Program” 
• “Effect of the Serious Illness Care Program in Outpatient Oncology, A Cluster-Randomized Clinical Trial”

Learn more about the Serious Illness Program and download the Serious Illness Conversation Guide here