Health-Related Values Discussions With Patients Receiving Allogeneic and Autologous Stem Cell Transplant and Chimeric Antigen Receptor Therapy (CAR-T): Implementation of an Early Nurse Practitioner-Led Primary Palliative Care Intervention.
Abigail G Cohen, Dana Kramer, Kathryn Mazzarella and 9 others
PMID 40845273WHAT IT FOUND
Nurse-led values discussions with 31 stem cell transplant or CAR-T patients were feasible and acceptable, and the program has since served over 150 patients and families.
This shows feasibility, not improved outcomes.
Key findings
01In the pilot, 141 values discussions were completed with 31 eligible patients, and only one declined continued participation.
02The vast majority reported that discussing their values was comfortable, meaningful, and helpful for themselves and their family caregivers, and they felt heard and understood by their care team.
03Since the program began, the NP team has provided the service to over 150 patients and families.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a single-center pilot and implementation report, not a controlled effectiveness trial. The pilot included 31 eligible patients, so it cannot establish how the intervention would work in a broader population. The paper reports feasibility and acceptability, not measured effects on advance directive completion, care alignment, end-of-life intensity, or quality of life. Patient and clinician feedback after expansion was informal and anecdotal. The program was implemented during a transition to a new electronic record system, and referrals reached only about 25% of new patients at the time described.
The easy way to misread this
Do not read this as proof that nurse-led values discussions improve outcomes. The paper reports a small pilot, implementation reach, and informal feedback, not a controlled trial of advance directive completion, care alignment, or end-of-life intensity.