# Conversational Agents to Improve Quality of Life in Palliative Care

> **NIH NIH R01** · BOSTON MEDICAL CENTER · 2020 · $247,127

## Abstract

Background: Although many interventions have now been developed to address palliative care for
specific chronic diseases, little has been done to address the overall quality of life for older adults with
serious illness, spanning not only the functional aspects of symptom and medication management, but
the affective aspects of suffering in a scalable and cost effective manner. Over the past decade we have
developed and tested embodied conversational agents (ECA) — computer characters that simulate face-
to-face conversation using voice, hand gesture, gaze cues and other nonverbal conversational behavior
to provide a natural and intuitive computer interface that is capable of expressing empathy and other
emotions. We have successfully developed and evaluated this interface in several clinical trials involving
older patients of all levels of health and computer literacy. We now propose to adapt this innovative
cutting edge technology to create and test a mobile ECA for palliative care (ECA-PAL) for patients with
advanced illnesses, spanning: symptom and medication tracking and management; assessment and
counseling to reduce social isolation, depression and unmet spiritual needs; and, promotion of and
communication about advance care planning.
Design: Randomized Controlled Trial
Hypotheses: In comparison to participants receiving usual care, ECA-PAL participants will: (1) have
greater quality of life; (2) a higher rate of receiving of palliative care services; (3) a lower rate of hospital
service utilization; and (4) lower cost per patient-month.
Population Studied: Adult patients at Boston Medical Center or affiliated Health Centers with life-limiting
illness, who’s clinician endorses that it would not be a surprise if the patient died within 12 months.
Methods: The ECA-PAL will be assessed with a randomized controlled trial of patients getting usual
care (n=182) or usual care plus ECA-PAL (n=182). Each participant will be enrolled along with a
caregiver surrogate subject.
Outcome Measures: The primary outcome is quality of life. Secondary outcomes will be measured in
the domains of receipt of palliative care services, hospital service utilization, cost, social isolation,
depression, anxiety, physical symptoms, spiritual needs, advance care planning. Caregivers will also be
interviewed to measure their quality of life.
Expected Results: In this project we will evaluate a scalable patient-centered intervention to improve
the quality of life for people with advanced illnesses.

## Key facts

- **NIH application ID:** 10117443
- **Project number:** 3R01NR016131-05S1
- **Recipient organization:** BOSTON MEDICAL CENTER
- **Principal Investigator:** TIMOTHY W. BICKMORE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $247,127
- **Award type:** 3
- **Project period:** 2016-04-22 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10117443

## Citation

> US National Institutes of Health, RePORTER application 10117443, Conversational Agents to Improve Quality of Life in Palliative Care (3R01NR016131-05S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10117443. Licensed CC0.

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