Preconsultation compassion video to reduce anxiety among patients referred to a cancer centre: a randomised control trial

Anxiety is common among patients attending an initial oncology consultation. The objective of this trial was to test if an enhanced compassion video emailed to patients prior to their initial oncology consultation reduces anxiety compared with being sent an information-only introduction video. We conducted a randomised control trial at a single university-based cancer centre between May 2021 and October 2023. We enrolled adult patients scheduled for an initial cancer consultation. Subjects underwent simple 1:1 randomisation to receive either a standard introduction video or an enhanced compassion video via email. Investigators and subjects were blinded to allocation. The primary outcome was degree of anxiety on arrival to the initial oncology consultation, measured using the Hospital Anxiety and Depression scale (HADS). Of 1005 subjects randomised to the standard video and 1038 to the enhanced compassion video, 183 and 179 subjects completed the HADS-anxiety in each group, respectively. Only 25% reported watching their assigned video. There was no difference in degree of anxiety between the standard or compassion video groups using intention to treat analysis (median (IQR) 7 (4-10) vs 7 (4-10), p value=0.473)) or per-protocol analysis (limited to subjects who reported watching the video) (median (IQR) 7 (4-10) (n=45) vs 7 (5-10) (n=46), p value=0.997). Receiving an enhanced compassion video did not reduce anxiety compared with a standard introduction video. Given 25% of subjects reported watching their assigned video, future research should focus on identifying interventions at the point-of-care to reduce anxiety. NCT04503681.