Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

‘Difficult’ Discussions Reduce Anxiety in Seriously Ill Cancer Patients

Key clinical point: A program to encourage difficult discussions between seriously ill patients and their oncologists reduced anxiety and depression, though goal-concordant care and peacefulness at the end of life did not differ from controls.

Major finding: At 14 weeks, patients receiving the intervention had less moderate to severe anxiety (10.2% vs. 5.0%; P = .05) and depression (20.8% vs. 10.6%; P = .04) versus controls.

Study details: A cluster randomized trial of a quality improvement intervention by 91 clinicians including 278 patients with advanced cancer.

Disclosures: Study coauthors provided disclosures related to Up to Date (Susan D. Block, MD) and a health care venture formed by Amazon, Berkshire Hathaway, and JP Morgan Chase (Atul A. Gawande, MD)


Bernacki R et al. JAMA Intern Med. 2018 Mar 14. doi:10.1001/jamainternmed.2019.0077.