Can a “prompt list” empower cancer patients to ask relevant questions?

Dimoska, Aneta; Tattersall, Martin H. N.; Butow, Phyllis; Shepherd, Heather L.; Kinnersley, Paul

doi:10.1002/cncr.23543

Cited by 154 publications

(139 citation statements)

References 46 publications

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“…This is consistent with the results of QPS use for oncology visits, in which a QPS also shifted the focus of the consultation. 22 The unexpected finding that counselees in the intervention group did not ask more questions might be due to the omission of example questions. A blank QPS was chosen to enable counselees to put forward their own agendas.…”

Section: Discussionmentioning

confidence: 99%

“…Counselors were instructed to endorse the QPS because previous studies showed that counselors should help counselees feel comfortable asking questions. 19,22 The instructions scripted them to refer to the QPS at the start of each intervention-group visit, to introduce the questions posed on the QPS if any, to welcome any other questions, and to add that counselees were welcome to interrupt them and that asking questions is important to fulfilling their needs. Counselors were reminded of the QPS by a printout of this question sheet, which was put in front of the medical file by a secretary.…”

Section: Methodsmentioning

confidence: 99%

“…A question prompt sheet (QPS), which prompts patients to articulate their questions before their consultation, has been shown effective in other settings. 20 Observation studies in oncology consultations have shown that QPS use increased patient question asking, 19,21,22 especially when the QPS was actively endorsed by the physician. 19 Additionally, patients were empowered to raise topics.…”

Section: Introductionmentioning

confidence: 99%

“…19 Additionally, patients were empowered to raise topics. 22 A randomized, controlled trial investigated whether a counselee activating intervention 23 could facilitate more tailored communication in the first visit for breast cancer genetic counseling. For this purpose, a pre-visit website providing computer-original research article 536 tailored information including a QPS, named E-info gene ca , was developed.…”

Section: Introductionmentioning

confidence: 99%

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A pre-visit website with question prompt sheet for counselees facilitates communication in the first consultation for breast cancer genetic counseling: findings from a randomized controlled trial

Albada

Dulmen

Ausems

et al. 2012

Genetics in Medicine

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original research article 535 Purpose: The initial breast cancer genetic counseling visit is mainly educational, with large amounts of relatively standard information and little counselee participation. Counselors might provide more counselee-specific information if counselees would participate more. A pre-visit website providing computer-tailored information and a question prompt sheet (QPS) might help counselees to pursue a more active role. methods:Counselees were randomized to receive usual care (UC) or UC plus the pre-visit website. The QPS questions were sent to the counselor before the visit. All counselees completed a baseline questionnaire, and visits were videotaped.Results: Intervention-group counselees (n = 102) did not ask more questions than UC-group counselees (n = 90). However, counselees in the intervention group more often shared their agenda (B = 10.37; confidence interval (CI) 2.68-18.06; P = 0.01), directed the communication (B = 0.41; CI 0.28-0.53; P = 0.01), and paraphrased the counselors' words (B = 5.18; CI 0.43-9.92; P = 0.03). Counselors introduced and answered the QPS questions. As a result, they provided more information about the topics of these questions, and the information provided was more specific to whether there was an indication for DNA testing.conclusion: A pre-visit website with QPS helped counselees to communicate more assertively. As a result, the information provided was more counselee specific, without affecting the visit duration.Genet Med 2012:14(5):535-542

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A pre-visit website with question prompt sheet for counselees facilitates communication in the first consultation for breast cancer genetic counseling: findings from a randomized controlled trial

Albada

Dulmen

Ausems

et al. 2012

Genetics in Medicine

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“…A variety of approaches have been used to support patients and clinicians to achieve SDM including decision aids, option grids, and question prompt list interventions which address specific health issues [23,24,25]. Within the context of a community-based adult education setting, students' ages and health status are varied so promoting SDM by teaching use of decision tools or option grids developed for specific clinical contexts is not appropriate or possible.…”

Section: Methodsmentioning

confidence: 99%

Development and field testing of a consumer shared decision-making training program for adults with low literacy

Muscat

Morony

Shepherd

et al. 2015

Patient Education and Counseling

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A c c e p t e d M a n u s c r i p t Highlights  We developed a comprehensive consumer SDM training program for adults with low literacy for delivery in education settings. The program aims to improve SDM knowledge, skills and self-efficacy.  Consumer input was fundamental in our iterative development process. *Highlights (for review)Page 2 of 34 A c c e p t e d M a n u s c r i p t as a means to engage in SDM during healthcare interactions. Conclusions:There is an ethical imperative to develop SDM interventions for adults with lower literacy. Generic training programs delivered direct-to-consumers in adult education settings offer promise in a national and international environment where too few initiatives exist.Practice implications: Formative evaluation of the program offers practical insights into developing consumer-focused SDM training. The content of the program can be used as a guide for future efforts to engage consumers in SDM.

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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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Can a “prompt list” empower cancer patients to ask relevant questions?

Cited by 154 publications

References 46 publications

A pre-visit website with question prompt sheet for counselees facilitates communication in the first consultation for breast cancer genetic counseling: findings from a randomized controlled trial

A pre-visit website with question prompt sheet for counselees facilitates communication in the first consultation for breast cancer genetic counseling: findings from a randomized controlled trial

Development and field testing of a consumer shared decision-making training program for adults with low literacy

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

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