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Client: Radboudumc

In collaboration with Radboud UMC, IJsfontein has developed an online web application for patients with advanced cancer for whom standard treatment is no longer possible. Sometimes they have the opportunity to participate in a study treatment (experimental treatment for which there is no evidence yet). These patients then face the difficult choice of whether or not to participate. The application can help them prepare for a (first) discussion about this. In addition, the application is intended for the oncologists who supervise these experimental treatments. They can use the application and the preparation that patients can go through at home to have a good conversation with the patients about the choice to make.

Gain insight into own values for making a good choice

Participation in study-based treatment can offer hope to patients, but usually does not provide direct benefit and can cause serious side effects. It is therefore important that patients make a personal decision based on what they consider important in the last phase of life. To prevent patients from having doubts about their final choice (‘decisional conflict’), the application must help them gain insight into what they themselves (still) consider important, how they want to proceed and which values are important for this.

 Getting to know peers

In Wandel, patients go on a virtual walk and get to know virtual persons who are in the same situation as themselves. These people tell their story and ask the patient (rhetorical) questions. In this way, patients hear thoughts from different perspectives that may play into considerations of whether or not to choose the experimental treatment. They may hear ideas that they agree or disagree with, that they think very differently about, or that they may not have thought about (yet). Based on this, patients can form their own opinions about the further interpretation of mostly the last chapter.

 Less decisional conflict

The application encourages patients to explore and record their own thoughts about what is important to them during difficult decisions in this final phase of their lives while listening. By discussing these insights with a practitioner, the practitioner can better reflect what is important to an individual patient during the consultation. This can support patients to make an appropriate decision about what is important to them in the last phase of life, which can contribute to quality of life in that phase.

The application is currently being used in a research project by Erasmus MC, but has also been implemented at Antoni van Leeuwenhoek and UMC Utrecht to capture its added value and gather feedback for possible further development.