Although there is a wealth of research highlighting the complex needs of patients with advanced cancer, robust research investigating the effectiveness of interventions remains sparse.1 The study by Bakitas and colleagues is unusual in two respects: first, randomised controlled trials are uncommon in palliative care because of problems with recruitment, ethical considerations and rigorously demonstrating cause and effect.2 Second, the study uses a telephone-based intervention described as a structured educational approach to encourage patient selfmanagement and empowerment.

The sample …