The Patient Concerns Inventory in head and neck oncology: a structured review of its development, validation and clinical implications

Abstract

Introduction The Patient Concerns Inventory (PCI) is a condition specific prompt list that was initially developed for head and neck cancer (HNC) and is referred to as the PCI–HN. There have been numerous publications regarding the PCI–HN, since it was first published in 2009. To date, there has not been a review of its development, validation and clinical implications. A collation of relevant papers into key sections allows multidisciplinary teams and researchers to have an overview of the PCI–HN’s background, evaluation and utility. This is essential if colleagues are to have confidence in the tool and be able to reflect on how to optimise its use in clinical practice. Methods Five search engines were used: EMBASE, Medline, PubMed, CINAHL and Handle-on-QOL for the specific term ‘Patient Concerns Inventory’ up to and including 1st February 2022. In addition, an accumulation of PCI–HN data of 507 HNC patients was drawn from previous studies in Liverpool and Leeds between 2007 and 2020 and was analysed specifically for this paper. Results 54 papers relating to the PCI–HN were identified. The review is structured into eight sections: (1) What is the PCI–HN and how does it work; (2) Feasibility and acceptability; (3) Psychometrics; (4) Items selected and frequency (5) Associations with Health-Related Quality of Life (HRQOL) and casemix; (6) Other observational studies; (7) Randomised trial evaluation; (8) General discussion and further research. Conclusions As the term PCI is quite ubiquitous and produces many hits when searching the literature, this review provides a very concise and convenient historical context for the PCI–HN and collates the current literature.

Concerns raised by people treated for head and neck cancer: a secondary analysis of audiotaped consultations in a health services follow-up clinic

“…We believe that if routinely introduced to HNC centres the PCI would prove to be a beneficial tool that significantly improved the communication process and facilitated discussions about patient concerns between HNC patients and consultant. Readers interested to apply the PCI in their clinical practise are advised to consult the original PCI literature [ 35 ].…”

Addressing patients’ concerns in speech and language therapy consultations following the diagnosis and treatment of head and neck cancer

“…The PCI-HN comprises of 56 items that cover concerns in relation to sequelae of treatment. It helps to focus the consultation, aid clinician-patient communication and is simple enough to use in routine practice [54 ▪▪ ]. There is evidence to support its use to enhance patient-centred care as the type and number of patients’ concerns reflect their HRQOL and psychological distress [55].…”

The Evaluation of Training Oral and Maxillofacial Trainees in Head and Neck Cancer Doctor-Patient Communication Using the Patient Concerns Inventory

“…The PCI-HN is an established prompt tool to help elicit patient concerns in routine HNC consultations (7); it is a 56-item prompt list completed by patients prior to their HNC consultation. The PCI-HN was first published in 2009 (8), and has been shown subsequently to be feasible as a cost-effective tool that improves health-related quality of life outcomes (9,10).…”