PB0961 - Towards cancer patient empowerment for optimal use of antithrombotic therapy at the end of life: a research protocol for the development and implementation of the SERENITY shared-decision support tool

Background: Despite the fact that antithrombotic therapy (ATT) has little or even negative effects on the well-being of cancer patients during their last year of life, active discontinuation or deprescribing ATT at the end of life is rare in daily practice. ATT is often continued until death, possibly resulting in excess bleeding, higher healthcare costs, and increased disease burden.

Aims: It is SERENITYs aim is to collect all required epidemiological, clinical, and patient-centred data to develop a shared-decision making tool that will facilitate informed decision making for optimal ATT in cancer patients at the end of life.

Methods: The SERENITY consortium comprises researchers and clinicians from nine European countries with specialties in different medical fields, epidemiology and psychology. SERENITY will use a comprehensive approach consisting of a combination of realist review, flash mob research, epidemiological studies and qualitative interviews. The results of these studies will be used in a Delphi process to reach consensus on the optimal design of the intervention. With this consensus, the shared-decision support tool (SDST) is designed and will then be tested and optimized in a randomized clinical trial. A targeted implementation and exploitation plan will be developed to enable the use of the SERENITY approach across Europe, as well as incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.

Results: SERENITY will develop an information-driven, palliative care shared decision-making process, enabled by an SDST that will facilitate treatment decisions regarding appropriate use of ATT in cancer patients at the end of life.

Conclusion(s): The intervention will ultimately lead to appropriate use of ATT, prevention of bleeding complications, and considerable cost savings in addition to enhanced empowerment, improved quality of life and treatment satisfaction of patients and their carers.