Question Prompt Lists in health consultations: A review

Sansoni, Janet; Grootemaat, Pamela E; Duncan, Cathy

doi:10.1016/j.pec.2015.05.015

Cited by 139 publications

(169 citation statements)

References 71 publications

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“…Question-prompt lists are designed as a simple, inexpensive way to support patients in gaining information about their diagnosis and treatment and improve doctor–patient communication by encouraging patients to actively participate in their health care (eg, ask questions, state concerns). 108–111 Active participation has been shown to influence the amount of information physicians provide, treatments they recommend, topics discussed, and patient psychosocial and physical health outcomes. 112–116 Question-prompt lists have been developed and tested in several medical settings, and, given the research showing that racially discordant interactions are often characterized by poor-quality communication, it is surprising that this type of intervention has not been tested in this context.…”

Section: Proposed Multilevel Interventional Modelmentioning

confidence: 99%

Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with Cancer

et al. 2016

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Background Clinical trials that study cancer are essential for testing the safety and effectiveness of promising treatments, but most people with cancer never enroll in a clinical trial — a challenge exemplified in racial and ethnic minorities. Underenrollment of racial and ethnic minorities reduces the generalizability of research findings and represents a disparity in access to high-quality health care. Methods Using a multilevel model as a framework, potential barriers to trial enrollment of racial and ethnic minorities were identified at system, individual, and interpersonal levels. Exactly how each level directly or indirectly contributes to doctor–patient communication was also reviewed. Selected examples of implemented interventions are included to help address these barriers. We then propose our own evidence-based intervention addressing barriers at the individual and interpersonal levels. Results Barriers to enrolling a diverse population of patients in clinical trials are complex and multilevel. Interventions focused at each level have been relatively successful, but multilevel interventions have the greatest potential for success. Conclusion To increase the enrollment of racial and ethnic minorities in clinical trials, future interventions should address barriers at multiple levels.

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Section: Proposed Multilevel Interventional Modelmentioning

confidence: 99%

Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with Cancer

et al. 2016

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“…The intervention was a question prompt list (QPL), a list of questions related to a medical condition that patients might want to ask their physician during clinic visits. QPLs are designed as a simple, inexpensive way to help patients gain more information about their diagnosis and treatment and enhance patient-provider communication[35–38]. Although QPLs have been used successfully in several oncology settings[31,39,40], they have not, as far as we know, been evaluated in the context of racially-discordant oncology interactions.…”

Section: Introductionmentioning

confidence: 99%

“…We defined active participation to include communication behaviors such asking questions, making assertions, and stating concerns[46, 47]. Based on prior research[35, 38], we expected patients who received the QPL in either format to participate more actively than patients who did not, and patients who received the QPL-plus-Coach to participate more actively than patients who received the QPL-Only.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have shown positive effects[35, 37, 38], including patient and observer perceptions of oncologist communication and patient reports of their role in treatment decisions and trust in their oncologist. These studies suggest that if patients participate more actively, oncologists may use more patient-centered communication and, as a result, patient post-interaction perceptions may be more positive.…”

Section: Introductionmentioning

confidence: 99%

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Randomized trial of a question prompt list to increase patient active participation during interactions with black patients and their oncologists

Eggly

Hamel

Foster

et al. 2017

Patient Education and Counseling

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Objective Communication during racially-discordant interactions is often of poor quality and may contribute to racial treatment disparities. We evaluated an intervention designed to increase patient active participation and other communication-related outcomes during interactions between Black patients and non-Black oncologists. Methods Participants were 18 non-Black medical oncologists and 114 Black patients at two cancer hospitals in Detroit, Michigan, USA. Before a clinic visit to discuss treatment, patients were randomly assigned to usual care or to one of two question prompt list (QPL) formats: booklet (QPL-Only), or booklet and communication coach (QPL-plus-Coach). Patient-oncologist interactions were video recorded. Patients reported perceptions of the intervention, oncologist communication, role in treatment decisions, and trust in the oncologist. Observers assessed interaction length, patient active participation, and oncologist communication. Results The intervention was viewed positively and did not increase interaction length. The QPL-only format increased patient active participation; the QPL-plus-Coach format decreased patient perceptions of oncologist communication. No other significant effects were found. Conclusion This QPL booklet is acceptable and increases patient active participation in racially-discordant oncology interactions. Future research should investigate whether adding physician-focused interventions might improve other outcomes. Practice Implications This QPL booklet is acceptable and can improve patient active participation in racially-discordant oncology interactions.

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“…[3, 18, 30] Our findings suggest the need for activation and communication skills training for companions to maximize their effectiveness during the visit. Strategies such as pre-visit question prompt lists, which help facilitate patient and family engagement in care have shown evidence of effectiveness [31–33], particularly if encouraged/endorsed by providers.…”

Section: Figurementioning

confidence: 99%

Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data

Cené

Haymore

Laux

et al. 2017

Patient Education and Counseling

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Objective-To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors.Methods-We collected survey data and audiotaped a single medical visit for 93 HF patients (36 brought a companion into the examination room) and their cardiology provider. Communication data was analyzed using the Roter Interaction Analysis System.Results-There were 32% more positive rapport-building statements (p<.01) and almost three times as many social rapport-building statements (p<0.01) from patients and companions in accompanied visits versus unaccompanied patient visits. There were less psychosocial information giving statements in accompanied visits compared to unaccompanied patient visits (p<0.01.) Providers made 25% more biomedical information giving statements (p=0.04) and almost three times more social rapport-building statements (p<0.01) in accompanied visits. Providers asked fewer biomedical and psychosocial questions in accompanied versus unaccompanied visits. Providers made 16% fewer partnership-building statements in accompanied versus unaccompanied visits (p=0.01).Conclusions-Our findings are mixed regarding the benefits of accompaniment for facilitating patient-provider communication based on survey and audiotaped data.Practice Implications-Strategies to enhance engagement during visits, such as pre-visit question prompt lists, may be beneficial.

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Question Prompt Lists in health consultations: A review

Cited by 139 publications

References 71 publications

Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with Cancer

Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with Cancer

Randomized trial of a question prompt list to increase patient active participation during interactions with black patients and their oncologists

Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data

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