Promoting patient participation and shortening cancer consultations: a randomised trial

Patient participation in medical consultations has been demonstrated to ben efit their subsequent psychological well being. Question asking is one way in which patients can be active. We investigated 2 means: of promoting canc er patient question asking. One was the provision of a question prompt shee t to patients prior to their initial consultation with their oncologist. Th e second was the active endorsement and systematic review of the question p rompt sheet by their oncologist 318 patients with heterogeneous cancers, se eing one of 5 medical and 4 radiation oncologists for the first time, were randomised to either receive or not receive a question prompt sheet. Doctor s were randomised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation. Anxiety was assessed prior to the consultation. Consultations were audiotaped and content analy sed. Anxiety was assessed again immediately following the consultation. Wit hin the next 10 days patients completed questionnaires assessing informatio n needs, anxiety and satisfaction and were given a structured telephone int erview assessing information recall. Patients provided with a question prom pt sheet asked more questions about prognosis compared with controls and on cologists gave significantly more prognostic information to these patients. Provision of the question prompt sheet prolonged consultations and increas ed patient anxiety; however, when oncologists specifically addressed the pr ompt sheet, anxiety levels were significantly reduced, consultation, durati on was decreased and recall was significantly improved. A patient question prompt sheet, used proactively by the doctor, is a powerful addition to the oncology consultation. (C) 2001 Cancer Research Campaign.