Perception of Helpfulness of a Question Prompt Sheet Among Cancer Patients Attending Outpatient Palliative Care

Background: Data on the use of question prompt sheets (QPSs) in palliative care are limited. Our team previously developed a single-page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients.

Methods: Hundred of 104 (96%) eligible patients and 68/68 (100%) caregivers received the QPS during their first palliative care clinic. Twelve palliative medicine specialists also participated in the study. Patient and physician perceptions about the QPS were assessed at the end of the visit. Patients' anxiety was also measured before and after consultation using the Spielberger State Anxiety Inventory.

Results: Among the responders, most agreed that the material was helpful in communicating with their doctor (77%), clear to understand (90%), had the right amount of information (87%), and they would use a similar material in the future (76%) and recommend it to other patients (70%). Overall, 92% were satisfied with their consultation visit. Physicians perceived that the QPS was helpful in 68% of the encounters and it did not prolong the consultation in 73% of the encounters. Physician agreement on helpfulness of the QPS was not significantly different from that of the patients (P = 0.3). Patient anxiety improved after consultation from a mean (SD) Spielberger State Trait Anxiety Inventory score of 39.2 (12.8) to 33.8 (10.7), P < 0.0001).

Conclusion: The QPS was perceived as helpful in patient-physician communication among advanced cancer outpatients and it did not increase patient anxiety. Physicians similarly reported that the QPS was helpful and it did not prolong clinic visits. Further research is needed for its widespread adoption and integration into routine clinical practice.