Towards Cancer Patient Empowerment for Optimal Use of Antithrombotic Therapy at the End of Life

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, stopping ATT is rare in clinical practice. In contrast, ATT is often continued until death, resulting in excess bleeding, higher healthcare costs, and increased disease burden. SERENITY will develop an information-driven, palliative care shared decision-making process enabled by a user-friendly, easily accessible, web-based shared decision support tool (SDST) that will facilitate treatment decisions regarding appropriate use of ATT in cancer patients at the end of life. SERENITY will use a comprehensive approach consisting of a combination of realist review, flash mob research, three epidemiologic studies in NL, UK, and DK, 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. Using the consensus reached in the Delphi process, the SDST will be designed to be patient-specific with adaption to gender, cancer-related, cultural, and socioeconomic factors. Proceeding, the SDST will be tested and optimised in a Randomised 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 national and pan-European clinical guidelines and policies. The intervention will ultimately lead to appropriate use of ATT, prevention of bleeding complications, and considerable cost savings in addition to improved quality of life and treatment satisfaction of patients, their carers, and involved healthcare professionals. The intervention will empower cancer patients and their carers, enabling them to make their own choices. The intervention will reduce the disease burden of hundreds of thousands of people living with cancer receiving palliative care each year, throughout all EU regions.