Patient- and Clinician-Directed Nudges Help Promote Serious Illness Conversations

July 2, 2024

A research team led by PC3I Associate Directors Ravi Parikh, MD, MPP, FACP and Samuel Takvorian, MD, MSHP found that behavioral economics-informed implementation strategies, called “nudges,” can help promote the completion of serious illness conversations (SICs) between patients with cancer and their clinicians. SICs, which elicit patient values, goals, and care preferences, are known to reduce anxiety and depression and improve quality of life in patients. However, these conversations occur infrequently, take place too late in a patient’s illness trajectory, or do not take place at all.

Findings published in JAMA Network Open demonstrated that together, nudges directed at both patients with high mortality risk and clinicians marginally increased the likelihood of participants engaging in SICs with their clinicians. The study, “Clinician- and Patient-Directed Communication Strategies for Patients With Cancer at High Mortality Risk,” is part of the Penn Implementation Science Center in Cancer Control (ISC3), which uses behavioral economics strategies to improve the efficiency and equity of cancer care delivery. More information on the study design and background can be found on the Serious Illness Conversations project page.