Development of a patient question prompt list to improve communication and clinical trial enrollment in a diverse patient population.

Abstract

143 Background: Few patients, especially racial/ethnic minorities, enroll in clinical trials (CT), in part due to patient-oncologist communication. Question prompt lists (QPLs) improve communication, but have not been tested in CT discussions in a diverse patient population. We describe the development and acceptability of a theory-based QPL to improve communication and enrollment of White and Black men in prostate cancer CTs. Methods: Two existing QPLs were adapted by a team of communication scientists, psychologists, clinicians and patients. Guiding theories were the common ingroup identity model, which suggests people from different social groups can better achieve goals when they are on the same team, and patient-centered communication, which suggests that patient active participation improves clinical communication. The revised QPL included text to encourage patients to see themselves and their oncologist as a team, and 33 questions about CTs to encourage patients to participate actively in clinical interactions that include a CT discussion. To test acceptability, we recruited 15 Black or White men currently enrolled in a prostate cancer CT at an urban comprehensive cancer center. We asked patients to provide feedback on the QPL, to endorse which questions were most important, and for suggested improvements. Results: Patients participated anonymously. All patients said the QPL would be useful. Four patients reported liking the graphics/layout. Six patients reported liking the team text, but one commented that it was unnecessary. Three patients liked that the QPL included many questions, several of which they had not thought to ask when they discussed a CT with their oncologist. Ten patients endorsed the questions they thought were important to ask (M = 24 questions, SD = 9). The most frequently endorsed questions were what is already known about this treatment and how serious are the side effects? Conclusions: Patients found the QPL to be acceptable and useful. The QPL was revised according to patient feedback. We are testing the revised QPL's influence on patient-oncologist communication about CTs, patient understanding of CTs offered, and patient decisions to enroll in a CT.