A Tailored Palliative Care Intervention (TARGET-PC) to Improve End-of-Life Care in Patients with Metastatic Breast Cancer
This clinical trial compares the effects of a tailored palliative care intervention (TARGET-PC) to enhanced usual care on end-of-life (EOL) care in patients with breast cancer that has spread from where it first started (primary site) to other places in the body (metastatic) and their caregivers. The diagnosis of metastatic breast cancer often leads to burdensome physical symptoms and treatment side effects. In addition, both patients and their caregivers often feel worried or sad about the cancer diagnosis. Clinical guidelines recommend an approach to EOL care that focuses on less aggressive treatment and more on improving symptoms and clarifying patients' goals and wishes. Studies have shown that involving a team of clinicians who specialize in lessening (or palliating) many of these distressing physical and emotional symptoms and in helping patients and their families cope with a serious illness improves patients' and their caregivers' experience with the cancer and its treatment. Studies have also shown that the palliative care team working closely with the oncology team may improve EOL care including patients' symptom control, quality of life (QOL), mood, and understanding of their illness. In addition, palliative care may decrease caregivers distress. Enhanced usual care includes electronic prompts to oncology providers with reminders to discuss and document patient preferences for end of life care. TARGET-PC may be more effective than enhanced usual care in improving symptoms, coping skills, illness understanding, and communication with the oncology team about preferences for care in patients with metastatic breast cancer (MBC) and their caregivers.