Navigating Advanced Illness Goals And Treatment With Digital Engagement (NAVIGATE)

Launched by NATIONAL UNIVERSITY OF SINGAPORE · Aug 14, 2025

Keywords

ClinConnect Summary

This clinical trial, called NAVIGATE, is studying whether a special interactive website can help family members or caregivers of seriously ill patients better prepare for important healthcare decisions. The goal is to see if this digital tool improves how caregivers engage in advance care planning—meaning conversations and decisions about the kind of medical care the patient would want in the future. Caregivers will use the website and answer a few questionnaires over six months, while patients themselves will only answer some questions without using the website.

To join, patients must be adults living in Singapore with serious illnesses like brain tumors, certain types of stroke, or advanced kidney disease, and they need to have a main caregiver involved in their care decisions. Caregivers must be adults who speak English and are actively involved in helping the patient with care or treatment decisions. Healthcare workers and people with memory problems aren’t eligible. Participants can expect to complete questionnaires at different times over six months, and caregivers will spend time exploring the website. This study aims to find out if this digital approach makes it easier for families to talk about and plan for future healthcare needs.

Gender

ALL

Eligibility criteria

• 1. Patient Participants Inclusion Criteria:
• • 1. Singapore resident aged 21years and above,
• • 2. patient able to identify one main caregiver in the care and medical decision-making for the patient;
• • 3. patient able to communicate in either English, Chinese, Malay or Tamil;
• • 4. patient meeting one of the following illness criteria: 4a. Patients with brain tumours: histological and/or radiological diagnosis of glioma or brain metastases.
• • 4b. Patients with spontaneous intracerebral haemorrhage (SICH) based on radiological diagnosis of SICH on baseline computed-tomographic scans.
• • 4c. Patients with CKD Stage 4 and 5, identified at G4 or G5 of CKD, glomerular filtration rate (GFR) 30 ml/min or less, inclusive of kidney failure on kidney replacement therapy; and (5) Physicians assessment that ACP is appropriate for the patient by physicians.\* (\*) The attending clinicians may base the assessment of ACP appropriateness on several factors in addition to high mortality risk. As a baseline, clinicians are asked to base their assessment of high mortality risk using the validated "Surprise" question.
• 2. Patient participants Exclusion Criteria:
• • 1. Patients unable to identify a caregiver who is a medical decision-maker,
• • 2. Patients are currently or was previously healthcare workers; or
• • 3. Patients are diagnosed with dementia or deemed cognitively impaired as determined by the Abbreviated Mental Test.
• 3. Caregiver Participants Inclusion Criteria:
• • 1. caregivers are identified as a medical decision-maker for the patient
• • 2. Singapore resident aged 21 years and above; and
• • 3. able to communicate in English
• 4. Caregiver Participants Exclusion Criteria:
• • 1. caregivers are currently or were previously healthcare workers;
• • 2. caregivers not involved in primary care of the patient (including providing care to the patient, supervision of care, or involved in making decisions regarding treatment the patient receives); or
• • 3. caregivers diagnosed with dementia.