Effect of question prompt lists for cancer patients on communication and mental health outcomes—A systematic review

Keinki, Christian; Momberg, Annika; Clauß, Katrin; Bozkurt, Gültekin; Hertel, Elizabeth; Freuding, Maren; Josfeld, Lena; Huebner, Jutta

doi:10.1016/j.pec.2021.01.012

Cited by 30 publications

(24 citation statements)

References 40 publications

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“…Cancer screening and treatment were the most studied condition for the SDM reviews, with three reviews showing positive effects [ 62 – 64 ] and 5 reporting potential benefits [ 65 – 69 ]. Two recent reviews reported unclear benefits [ 70 , 71 ]. One review identified 10 studies focused on cancer treatment decision-making specifically for patients from racial and ethnic minority backgrounds, and showed improved patient engagement outcomes (i.e., higher satisfaction, improved communication) [ 64 ] (Table S2 ).…”

Section: Resultsmentioning

confidence: 99%

Patient engagement strategies for adults with chronic conditions: an evidence map

et al. 2022

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Background Patient and family engagement (PFE) has been defined as a partnership between patients, families, and health care providers to achieve positive health care outcomes. There is evidence that PFE is critical to improving outcomes. We sought to systematically identify and map the evidence on PFE strategies for adults with chronic conditions and identify areas needing more research. Methods We searched PubMed, CINAHL, EMBASE, and Cochrane, January 2015 to September 2021 for systematic reviews on strategies for engaging patients with chronic conditions and their caregivers. From each review, we abstracted search dates, number and type of studies, populations, interventions, and outcomes. PFE strategies were categorized into direct patient care, health system, and community-policy level strategies. We found few systematic reviews on strategies at the health system, and none at the community-policy level. In view of this, we also searched for original studies that focused on PFE strategies at those two levels and reviewed the PFE strategies used and study findings. Results We found 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. Four original studies addressed PFE at the health system or community-policy levels. Most direct patient care reviews focused on self-management support (SMS) (n = 85) and shared decision-making (SDM) (n = 43). Forty-nine reviews reported positive effects, 35 reported potential benefits, 37 reported unclear benefits, and 4 reported no benefits. Health system level strategies mainly involved patients and caregivers serving on advisory councils. PFE strategies with the strongest evidence focused on SMS particularly for patients with diabetes. Many SDM reviews reported potential benefits especially for patients with cancer. Discussion Much more evidence exists on the effects of direct patient care strategies on PFE than on the effects of health system or community-policy strategies. Most reviews indicated that direct patient care strategies had positive effects or potential benefits. A limitation of this evidence map is that due to its focus on reviews, which were plentiful, it did not capture details of individual interventions. Nevertheless, this evidence map should help to focus attention on gaps that require more research in efforts to improve PFE.

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Section: Resultsmentioning

confidence: 99%

Patient engagement strategies for adults with chronic conditions: an evidence map

et al. 2022

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“…QPLs seem effective in raising patients’ asking questions [ 38 , 42 , 94 ]; however, a complementary coaching intervention may be needed to further patients’ support [ 95 , 96 , 97 ]. Coaching is the provision of nondirective support by an individual (either in-person or remotely eg, by telephone or the internet) [ 98 ].…”

Section: Discussionmentioning

confidence: 99%

“…A QPL includes a structured list of questions given to the patient before the consultation. This intervention drives patients to more frequently ask questions and express concerns, especially regarding disease prognosis, and may enhance patients’ recall of information and satisfaction with care [ 38 , 39 , 41 , 42 , 44 - 48 ].…”

Section: Introductionmentioning

confidence: 99%

Helping Patients Communicate With Oncologists When Cancer Treatment Resistance Occurs to Develop, Test, and Implement a Patient Communication Aid: Sequential Collaborative Mixed Methods Study

Brédart¹,

Terrasson²,

Seigneur³

et al. 2022

JMIR Res Protoc

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Background Most cancer-related deaths result from disseminated diseases that develop resistance to anticancer treatments. Inappropriate communication in this challenging situation may result in unmet patient information and support needs. Patient communication aids such as question prompt lists (QPLs) may help. Objective This study aims to develop and pilot-test a specific QPL in the following two contrasting clinical contexts in France after cancer resistance has developed: triple-negative and luminal B metastatic breast cancer (MBC) and metastatic uveal melanoma (MUM). Methods A sequential study design with a mixed methods collaborative approach will be applied. The first step aims to build a specific QPL. Step 1a will explore oncologist-patient communication issues from oncology professionals’ interviews (n=20 approximately). Step 1b will appraise information and support needs experienced by patients with MBC or MUM both quantitatively (n=80) and qualitatively (n=40 approximately). These data will be used to develop and pilot-test a QPL specific to patients with cancer experiencing initial or acquired resistance to treatment. We expect to obtain a core QPL that comprises questions and concerns commonly expressed by patients with resistant cancer and is complemented by specific issues for either MBC or MUM cancer sites. In step 1c, 2 focus groups of patients with any type of metastatic cancer (n=4) and health care professionals (n=4) will be conducted to revise the content of a preliminary QPL and elaborate an acceptable and feasible clinical implementation. In step 1d, the content of the QPL version 1 and implementation guidance will be validated using a Delphi process. Step 2 will pilot-test the QPL version 1 in real practice with patients with MBC or MUM (n=80). Clinical utility will be assessed by comparing responses to questionnaires administered in step 1b (QPL-naive historical control group) and step 2 (QPL intervention group). Results This study received grants in March and December 2019 and was approved by the French national ethics committee in July 2019. As of October 2021, interviews with oncology professionals have been conducted and analyzed (N=26 to reach saturation), and 39 and 27 patients with MBC and MUM, respectively, have been recruited. Conclusions A clinically and culturally tailored QPL is expected to facilitate patients’ participation in consultations, improve oncologists’ responses to patients’ information and support needs, and thus foster patients’ psychological adjustment to the diagnosis and follow-up of cancer resistance to treatment. Trial Registration ClinicalTrials.gov NCT04118062; http://clinicaltrials.gov/ct2/show/NCT04118062 International Registered Report Identifier (IRRID) DERR1-10.2196/26414

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“…The use of a QPL appears to alleviate the feeling among patients that they are overwhelmed with information they do not necessarily expect and enables them to find the right moment to express their concerns [27]. In addition, QPLs help patients to avoid missing questions that matter to them [34 ▪▪ ]. The use of these tools can also tailor aspects usually discussed during interactions with physicians in accordance to patients’ wishes [34 ▪▪ ] and facilitate and normalize discussions on the relevant aspects notably around the end-of-life period [27].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, QPLs help patients to avoid missing questions that matter to them [34 ▪▪ ]. The use of these tools can also tailor aspects usually discussed during interactions with physicians in accordance to patients’ wishes [34 ▪▪ ] and facilitate and normalize discussions on the relevant aspects notably around the end-of-life period [27].…”

Section: Introductionmentioning

confidence: 99%

Question prompt lists to improve communication between cancer patients and healthcare professionals

Terrasson

Rault

Dolbeault

et al. 2022

Current Opinion in Oncology

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Purpose of reviewThis literature review sets out to summarize knowledge on the impact of question prompt lists (QPLs) on patient-physician communication in oncology and to provide an account of current research on the development, adaptation, and implementation of this type of communication tool.Recent findingsProvided with a QPL, patients seem to ask more questions, in particular on sensitive issues like those around the end-of-life period and they recall the information provided better. There is a need to adapt QPLs, taking account of divergences in attitudes towards illness, participation in decision-making, and discussions about the illness prognosis across cultures. QPLs may also need to be tailored to specific concerns of patients at the different stages in the care trajectory and to the particularities of each cancer type. These adaptations contribute to the effectiveness of the tool because they make it possible to tailor it to the challenges and constraints experienced in clinical practice.SummaryQPLs are designed to enhance patients’ communication with their physicians. Further research is required to develop QPLs suited to each cultural and clinical setting, involving health professionals so as to facilitate the implementation of these tools in routine practice.

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Effect of question prompt lists for cancer patients on communication and mental health outcomes—A systematic review

Cited by 30 publications

References 40 publications

Patient engagement strategies for adults with chronic conditions: an evidence map

Patient engagement strategies for adults with chronic conditions: an evidence map

Helping Patients Communicate With Oncologists When Cancer Treatment Resistance Occurs to Develop, Test, and Implement a Patient Communication Aid: Sequential Collaborative Mixed Methods Study

Question prompt lists to improve communication between cancer patients and healthcare professionals

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