Facilitating advance care planning in oncology: study protocol for the evaluation of a tailored implementation of an advance care planning tool (the INDEED study).
4 affiliations
- 1Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, the Netherlands. [email protected].
- 2Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
- 3Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands.
- 4Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, the Netherlands.
Abstract
Background
Advance care planning (ACP) improves patient outcomes, but integration of ACP in daily practice for patients with cancer in hospitals remains suboptimal. Systematic implementation of tools to facilitate ACP could overcome the barriers for ACP. In this study we will evaluate the multifaceted tailored implementation of a digital ACP tool embedded in the electronic health record (EHR) in daily clinical cancer care. We will analyse the implementation process, its effect on use of the ACP tool, and the impact of use of the tool on healthcare use and healthcare costs.Methods
We will perform a multicentre, convergent mixed-methods implementation study. The digital ACP tool supports healthcare professionals in conducting and documenting ACP conversations, and sharing this documentation with colleagues within and outside the hospital. The implementation will encompass four phases guided by the Implementation of Change model: 1) diagnostic analysis; 2) tailored implementation protocol development; 3) protocol implementation and testing; and 4) evaluation of the implementation process and its effects. We will evaluate both qualitative and quantitative aspects of the implementation process. Additionally, use of the tool and its impact on in-hospital healthcare use in the last three months of life and associated costs are measured.Discussion
This study will provide knowledge on how to effectively implement ACP in routine care in hospitals for patients with cancer, by identifying effective implementation strategies. Furthermore, it will give insight in the effect of integration of ACP conversations in daily clinical care on healthcare use of patients with cancer in the last three months of life and the associated costs.Trial registration
This study is registered at ClinicalTrials.gov (NCT06350968, Registration date: April 8, 2024).
Related
- Implementation science in global paediatric oncology: a scoping review protocol.
- The implementation and evaluation of an advance care planning education intervention in a long-term care facility: a feasibility study.
- Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA)
- Co-development, initial evaluation and implementation of a digital health intervention (SmartADHD) for young people (aged 16-30) with attention deficit hyperactivity disorder, including optimisation for sustainable delivery via health and social care settings: protocol for a mixed-methods study.
- Implementation of a complex intervention for hip fracture care: a protocol for an embedded mixed-methods process evaluation of a multicentre cluster randomised trial in India, Nepal, the Philippines, Thailand and Vietnam.
BibTeX
@article{benschop2026facilitating,
title = {{Facilitating advance care planning in oncology: study protocol for the evaluation of a tailored implementation of an advance care planning tool (the INDEED study).}},
author = {Joica A M Benschop and Ida J Korfage and Agnes van der Heide and Annemieke van der Padt-Pruijsten and Carin C D van der Rijt and Wendy H Oldenmenger},
journal = {BMC palliative care},
year = {2026},
month = aug,
doi = {10.1186/s12904-026-02285-9},
url = {https://europepmc.org/article/MED/42920159},
note = {CC BY},
}
RIS
TY - JOUR
TI - Facilitating advance care planning in oncology: study protocol for the evaluation of a tailored implementation of an advance care planning tool (the INDEED study).
AU - Joica A M Benschop
AU - Ida J Korfage
AU - Agnes van der Heide
AU - Annemieke van der Padt-Pruijsten
AU - Carin C D van der Rijt
AU - Wendy H Oldenmenger
PY - 2026
DA - 2026/08/01
JO - BMC palliative care
DO - 10.1186/s12904-026-02285-9
UR - https://europepmc.org/article/MED/42920159
AB - Background Advance care planning (ACP) improves patient outcomes, but integration of ACP in daily practice for patients with cancer in hospitals remains suboptimal. Systematic implementation of tools to facilitate ACP could overcome the barriers for ACP. In this study we will evaluate the multifaceted tailored implementation of a digital ACP tool embedded in the electronic health record (EHR) in daily clinical cancer care. We will analyse the implementation process, its effect on use of the ACP tool, and the impact of use of the tool on healthcare use and healthcare costs.Methods We will perform a multicentre, convergent mixed-methods implementation study. The digital ACP tool supports healthcare professionals in conducting and documenting ACP conversations, and sharing this documentation with colleagues within and outside the hospital. The implementation will encompass four phases guided by the Implementation of Change model: 1) diagnostic analysis; 2) tailored implementation protocol development; 3) protocol implementation and testing; and 4) evaluation of the implementation process and its effects. We will evaluate both qualitative and quantitative aspects of the implementation process. Additionally, use of the tool and its impact on in-hospital healthcare use in the last three months of life and associated costs are measured.Discussion This study will provide knowledge on how to effectively implement ACP in routine care in hospitals for patients with cancer, by identifying effective implementation strategies. Furthermore, it will give insight in the effect of integration of ACP conversations in daily clinical care on healthcare use of patients with cancer in the last three months of life and the associated costs.Trial registration This study is registered at ClinicalTrials.gov (NCT06350968, Registration date: April 8, 2024).
SN - 1472-684X
ER -