Development of a question prompt sheet for cancer patients receiving outpatient palliative care.

Abstract

Background: A question prompt sheet (QPS) is a structured list of potential questions available for patients to ask their doctor during a clinical encounter. Although it has been shown to improve physician-patient interaction during clinical consultations, there is paucity of data on its use in the palliative care setting. The aim of this study was to develop a single-page consensus list of prompt questions for use by patients attending outpatient palliative care. Method: An expert group of experienced physicians and mid-level providers were invited to participate in the study conducted in three Delphi rounds. A consensus in this study was defined a priori as an agreement (i.e., agree or strongly agree) by a minimum of 80% of the experts. Results: One hundred percent of the 22 invited experts participated in all the three Delphi rounds of the study. The top 25 questions with the highest level of endorsement were chosen and used toward the development of the QPS. Twenty-eight percent of the questions were about symptoms, treatment, and lifestyle, 24% were about commonly asked questions by caregivers, 20% were regarding end-of-life issues, 16% were regarding the nature of the palliative care service, and 12% were regarding the type of available support. Conclusion: A 25-item, single-page QPS was developed for use by patients attending outpatient palliative care. Further studies are needed to determine its clinical effectiveness in assisting physician-patient communication.

Development of a question prompt list for women with polycystic ovary syndrome

“…However, similar to a previous QPL approach (26) we elected to include questions that would apply to a range of women. Compared with existing QPLs (e.g., for advanced cancer and palliative care patients) (18)(19)(20)25), the PCOS QPL is longer. However, most of the women agreed that the length was appropriate given the chronic and multifaceted nature of PCOS.…”

“…A question prompt list (QPL) is a structured list of questions used by patients and/or their caregivers during medical consultations, designed to empower patients and optimize patientcentered care (17). Question prompt lists have been widely investigated in the settings of cancer (18)(19)(20)(21)(22)(23), palliative care (24,25), chronic conditions including attention deficit/ hyperactivity disorder (26), and chronic obstructive pulmonary disease (27). They have been found to assist patients and caregivers to put their concerns into words (28), discuss difficult or sensitive issues (24), and ask more targeted questions (20,22,29).…”

The Question‐prompt list (QPL): Why it is needed in the Indian oncology setting?

“…The initial stage of developing a QPL includes conducting a qualitative study such as a focus group discussion (FGD) (eg, References 27,28), individual interviews (eg, References 29,30), expert panels (eg, References 31‐33), or using a Delphi method (eg, References 34‐36) to understand the specific questions that could usefully be asked by the target population regarding their illness and/or treatment. A few studies used previously published QPLs which were reviewed and modified by a panel (ie, patient, family caregivers, and healthcare professionals) 31,35,37 . Through these qualitative methods and subsequent data analyses, a draft list of questions is generated for the patient/caregiver to use at the treatment consultation.…”

“…As questions patients may have can vary according to the type and stage of the illness and treatment, 1,3,9,11,12 QPLs have been developed for specific oncology‐related illness and treatment contexts: type of cancer such as esophageal, 31 breast, 34 and brain, 37 ; for patients in a surgical setting or undergoing chemotherapy 38 ; patients being invited to participate in clinical trials 27 ; when receiving outpatient palliative care 35 ; and to facilitate end‐of‐life discussions and advance care planning among patients with an advanced cancer 32 . More recently, a QPL was developed for family members of paediatric palliative care patients 36 .…”