A-EPAC for Cancer

(A-EPAC Trial)

This trial aims to improve conversations between veterans with cancer and their doctors about end-of-life care preferences. It combines two methods: support from a lay health worker who guides these discussions and a tool that identifies patients needing urgent talks with their care teams. Participants receive standard cancer care, plus additional support through phone sessions to better engage in these conversations. This trial suits veterans with any stage of solid cancer who are receiving cancer treatment, speak English or Spanish, and have a valid phone number. As an unphased trial, it offers a unique opportunity to enhance communication and support during cancer treatment.

Research has shown that the A-EPAC treatment, which involves a lay health worker leading education sessions, is generally well-received by patients. Studies indicate that discussing care with patients can reduce anxiety and enhance overall well-being. No direct evidence links A-EPAC to serious side effects or negative events. In fact, similar approaches using patient feedback have effectively identified and managed side effects. This suggests that A-EPAC is likely a safe option for patients considering joining the trial.¹²³⁴⁵

Researchers are excited about the A-EPAC approach because it goes beyond usual cancer care by integrating personalized support and education into the treatment process. Unlike standard treatments that focus solely on medical interventions, A-EPAC assigns patients a lay health worker who conducts regular phone sessions. These sessions aim to empower patients by discussing their goals and helping them communicate more effectively with their clinical teams. This personalized support could potentially lead to improved patient outcomes and a more engaged approach to managing cancer care.

Research has shown that the A-EPAC treatment can benefit patients with advanced cancer. In this trial, participants in the "Usual Care + A-EPAC" arm will receive education sessions and discussions about care goals, alongside usual cancer care. One study found that patients who received A-EPAC had a 25% lower risk of death and made more use of palliative care and hospice services. These patients also experienced fewer hospital stays and emergency room visits, indicating better health management. Another study found that the treatment increased overall survival rates and reduced the need for urgent medical care. These results suggest that A-EPAC can improve the quality of life and healthcare outcomes for cancer patients by encouraging important discussions about care goals.¹⁴⁶⁷⁸