Advanced cancer patients’ and caregivers’ use of a Question Prompt List

Brandes, Kim; Butow, Phyllis; Tattersall, Martin H. N.; Clayton, Josephine M.; Davidson, Patricia M.; Young, Jane; Epstein, Ronald M.; Walczak, Adam

doi:10.1016/j.pec.2014.06.010

Cited by 52 publications

(36 citation statements)

References 37 publications

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“…10,14,15 Yet patients are often reluctant to be assertive, ask questions, request clarification, express emotions directly, or state opinions and preferences. 16 As death approaches, patients express considerable ambivalence about end-of-life discussions, often indicating that now is “not the right time.” 17–20 Similarly, while most clinicians indicate willingness to have these discussions “now,” few follow through. 21,22 More typically, clinicians wait for patients to signal interest, then offer prognostic information that is optimistically biased.…”

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confidence: 99%

Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer

et al. 2016

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IMPORTANCE Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. OBJECTIVE To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life. DESIGN, SETTING, AND PARTICIPANTS Cluster RCT at community- and hospital-based cancer clinics in Western New York and Northern California; 38 medical oncologists (mean age 44.6 years; 11 (29%) female) and 265 community-dwelling adult patients with advanced nonhematologic cancer participated (mean age, 64.4 years, 146 [55.0%] female, 235 [89%] white; enrolled August 2012 to June 2014; followed for 3 years); 194 patients had participating caregivers. INTERVENTIONS Oncologists received individualized communication training using standardized patient instructors while patients received question prompt lists and individualized communication coaching to identify issues to address during an upcoming oncologist visit. Both interventions focused on engaging patients in consultations, responding to emotions, informing patients about prognosis and treatment choices, and balanced framing of information. Control participants received no training. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was a composite measure of patient-centered communication coded from audio recordings of the first oncologist visit following patient coaching (intervention group) or enrollment (control). Secondary outcomes included the patient-physician relationship, shared understanding of prognosis, QOL, and aggressive treatments and hospice use in the last 30 days of life. RESULTS Data from 38 oncologists (19 randomized to intervention) and 265 patients (130 intervention) were analyzed. In fully adjusted models, the intervention resulted in clinically and statistically significant improvements in the primary physician-patient communication end point (adjusted intervention effect, 0.34; 95% CI, 0.06–0.62; P = .02). Differences in secondary outcomes were not statistically significant. CONCLUSIONS AND RELEVANCE A combined intervention that included oncologist communication training and coaching for patients with advanced cancer was effective in improving patient-centered communication but did not affect secondary outcomes. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01485627

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confidence: 99%

Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer

et al. 2016

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“…Research has shown that their use is associated with more question asking by patients, higher levels of information satisfaction, and a reduction of unmet information needs [14,[29][30][31][32][33]. Patients rate QPL as helpful [30,[34][35][36][37][38] and are more satisfied with consultations in which QPL were used [39].…”

Section: Introductionmentioning

confidence: 99%

Beyond Oncology: Question Prompt Lists in Healthcare—A Scoping Review Protocol

Lukasczik

Gerlich

Wolf

et al. 2020

MPs

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Question prompt lists (QPL) are an instrument to promote patient participation in medical encounters by providing a set of questions patients can use during consultations. QPL have predominantly been examined in oncology. Less is known about their use in other contexts. Therefore, we plan to conduct a scoping review to provide an overview of the fields of healthcare in which QPL have been developed and evaluated. MEDLINE/PUBMED, PSYCINFO, PSYNDEX, WEB OF SCIENCE, and CINAHL will be systematically searched. Primary studies from different healthcare contexts that address the following participants/target groups will be included: persons with an acute, chronic, or recurring health condition other than cancer; healthy persons in non-oncological primary preventive measures. There will be no restrictions in terms of study design, sample size, or outcomes. However, only published studies will be included. Studies that were published in English and German between 1990 and 2019 will be examined. Two independent reviewers will apply defined inclusion/exclusion criteria and determine study eligibility in the review process guided by the PRISMA statement.

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“…This might lead to unmet needs [2]. The Patient Concerns Inventory (PCI) was developed as an item prompt list [3][4][5]. Patients complete the tool whilst waiting for their consultation and any issues they identify can be discussed during the consultation.…”

Section: Introductionmentioning

confidence: 99%

How easy and confident do patients feel about using an iPad to complete the Patient Concerns Inventory without assistance in a busy head and neck oncology outpatient review clinic

2017

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Introduction This project aims to evaluate the ease and confidence of patients when using an iPad to complete an item prompt list (Patient Concerns Inventory) in a busy oncology outpatient clinic. Patients and methods 100 consecutive patients attending routine maxillofacial oncology review clinic completed a study specific 5 item self-report questionnaire after completion of the PCI. Results Of eligible patients attending 14 clinics from March 2016 onwards, one-third (31) preferred to complete the PCI on an iPad with a volunteer in a separate room, while two-thirds (69) preferred to complete the PCI by themselves on an iPad in the waiting room. Previous use of an iPad and patient age ([70) were factors indicating lower confidence and a preference towards needing help in a separate room. Although the majority of patients were able to complete the PCI in the waiting room themselves there is a proportion who for a variety of reasons would prefer to have assistance. Conclusion This study helps to inform resource allocation (assistance and clinic area) when adopt the PCI across the whole oncology outpatient setting. Further research is needed to identify cost efficient ways to promote the selfcompletion of the PCI in those patients less confident.

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Advanced cancer patients’ and caregivers’ use of a Question Prompt List

Cited by 52 publications

References 37 publications

Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer

Effect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer

Beyond Oncology: Question Prompt Lists in Healthcare—A Scoping Review Protocol

How easy and confident do patients feel about using an iPad to complete the Patient Concerns Inventory without assistance in a busy head and neck oncology outpatient review clinic

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