Question Prompt List Research Articles

Evaluation of a Question Prompt List About Cardiovascular Disease Risk and Prevention After Hypertensive Pregnancy: A Pilot Study.

The aim of this study was to pilot test a question prompt list (QPL) about cardiovascular disease (CVD) risk reduction after hypertensive pregnancy (HDP). In a prospective cohort study of adult women who had HDP given the QPL before and surveyed after a physician visit, we assessed perceived person-centred care, self-efficacy for self-management, perceived self-management and QPL feasibility. Twenty-three women participated: 57% of diverse ethno-cultural groups, 65% < 40 years of age and 48% immigrants. Most scored high for person-centred care (mean 4.1 ± 0.2/5); and moderately for self-efficacy (mean 7.4 ± 0.6/10) and self-management (mean 3.1 ± 0.3/5). Most appreciated QPL design and reported QPL benefits: helped them to prepare for the visit and know what to ask; increased confidence to ask questions, knowledge of the link between HDP and CVD and lifestyle behaviours to reduce CVD risk. Most reported that physicians were receptive to discussing QPL questions. Women appreciated the QPL and knowledge about self-management was high but self-efficacy for or perceived self-management was moderate. It appears feasible to share a QPL with ethno-culturally diverse women who can share it with physicians to facilitate discussions about post-pregnancy HDP-related CVD risk. This study involved women who experienced HDP and engaged ethno-culturally diverse women with lived experience of HDP as study advisors in all stages of the research.

Esophageal Expert Development of a Preliminary Question Prompt List for Adults With Eosinophilic Esophagitis: A Modified Delphi Study.

Question prompt lists (QPLs) are structured sets of disease-specific questions intended to encourage question-asking by patients and enhance patient-physician communication. To date, an EoE-specific QPL has not been developed for EoE patients. To develop a preliminary QPL specific to adults with EoE by incorporating input from international esophageal experts. Sixteen experts were invited to generate QPL content through a modified Delphi (RAND/University of California, Los Angeles, CA) method consisting of 2 rounds of independent ratings. In round 1, experts provided 5 answers to the prompts "what general questions should patients ask when being seen for EoE?" and "what questions do I not hear patients asking but given my experience, I believe they should be asking?" In round 2, experts rated each question on a 5-point Likert scale, and responses rated as "essential" or "important" (determined by an a priori median threshold of ≥ 4.0) were accepted for the EoE QPL. Ten esophageal experts participated in both rounds. Round 1 generated 100 questions. Questions were combined and modified to reduce redundancy, yielding 57 questions. After round 2, 51 questions (85%) were accepted for inclusion (median value ≥ 4.0) in the final QPL. Questions were then divided into 4 themes based on disease domains: (1) "What is EoE?," (2) "Treatment Options," (3) "Follow-up Surveillance and Long-term Risks," and (4) "Allergy and Genetic Testing." The largest number of questions covered was "What is EoE?" (16/51 or 31%). Questions with the highest agreement median (5.0) included examples such as "what should I do if I get a food impaction?" and "what are the treatment options?" This is the first preliminary EoE QPL developed in the field of medicine. We hope implementation enhances effective patient-physician communication by encouraging patients to ask relevant questions that experts prioritized. Future studies will aim to modify this communication tool by incorporating patient perspectives.

Facilitating patient-oncologist communication in advanced treatment-resistant cancer: development and feasibility testing of a question prompt list

BackgroundPatients’ expectations regarding medical information in advanced stages of cancer are still poorly understood. Tailoring information to advanced cancer patients is a subtle task. We developed a question prompt list (QPL) that serves as a patient-oncologist communication aid in France.MethodsA four-step sequential mixed method involving patients with luminal B/triple-negative metastatic breast cancer or metastatic uveal melanoma (N = 110) and patients’ partners, oncologists, and researchers (N = 18) was used. In-depth interviews and questionnaires focused on the information needed at the disclosure of metastasis or resistance to treatment (step 1), the formulation of questions and procedures for use in oncology visits (steps 2 and 3), and the acceptability of the final tool (stage 4).ResultsThe initial version of the QPL consists of 17 questions covering 5 themes (disease, current treatment, other options, living with cancer, prognosis). In step 2, 13 questions were added, 2 were merged, and 5 were deleted; a short form (4 questions) and recommendations for clinical use were proposed. In step 3, 2 questions were merged, and 6 were deleted. Four oncologists (27% of the target population) took part in step 4, and the QPL was discussed with 20 patients, revealing a positive appraisal.ConclusionWe provide a rigorously developed, relevant, concise, and acceptable question prompt list for clinical application in the advanced cancer care setting in France. Further research needs to assess whether this tool actually facilitates oncologist–patient communication and improves satisfaction with care and health outcomes.Trial registrationThe study is listed on ClinicalTrials.gov (NCT04118062) and registered under identification n° IRRID “International Registered Report Identifier”: DERR1-10.2196/26414.

Improving young patient- practitioner communication about sexual health during medical visits.

Young people face barriers that lead to gaps in sexual and reproductive health care communications. Issues such as discomfort discussing sexual health lead to inadequate delivery of services resulting in unintended pregnancies and STIs. Closing this communication gap between patients and health care practitioners would improve communication and health outcomes. The objective of this study was to gain feedback from focus groups about: (a)barriers and facilitators to communication surrounding sexual health and (b)the feasibility and acceptability of a question prompt list (QPL) and informational video emphasizing asking questions about sexual health during medical visits as tools young people could use to be more involved during visits. Three focus groups were conducted: two with young adults (n=14) and one with practitioners (n=5) of sexual/reproductive health care services. Practitioners were recruited from healthcare clinics. Young adults were aged 18-22 years old. Participants identified barriers to communication such as embarrassment over sexual health topics and practitioner assumptions about patients' base of knowledge. A facilitator to communication was patient-friendly language. Focus group participants offered suggestions on how to improve the QPL as well as themes that should be covered in an educational video. Participants viewed the QPL and educational video as useful for encouraging conversations between patient and practitioner. Many barriers obstruct communication between young adults and practitioners on topics relating to sexual health. Both the QPL and an educational videocould be used to enhance patient-practitioner communication.

Geriatric assessment and management with question prompt list using a web-based application for elderly patients with cancer to communicate aging-related concerns: A randomized clinical trial (J-SUPPORT 2101 study).

1511 Background: Older adults with cancer have aging-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these aging-related problems and guide management. Communication support might also facilitate implementation of GA-guided management (GAM). We conducted this single-blind, parallel-group, multicenter, randomized controlled trial to evaluate the efficacy of a program providing GAM recommendation and communication support between older Japanese patients with cancer and their oncologists. Methods: Eligibility criteria were age≥70 years, advanced or recurrent cancers of gastrointestinal origin, referral to one of the two institutions for first- or second-line systemic therapy, and impairment in at least one GA domain as assessed using a web-based application at baseline. In the intervention group, GAM recommendations and question prompt list (QPL) were provided to patients by trained intervention providers to be shared with their oncologists at the first outpatient visit after randomization. Over 5 months after the initial intervention, implementation of GAM recommendations was reviewed monthly by the intervention providers with the patients and their oncologists. Patients in the control group received usual care. The primary endpoint was the number of conversations about aging-related concerns at the first visit. The quality of conversations was assessed in terms of the number of conversations in which stated concerns were acknowledged and considered further by the oncologist and the number of conversations in which acknowledged concerns motivated implementation of GAM recommendations. Results: A total of 215 patients (99 women, 116 men; median age 75 [range 70-88] years) were randomized (n=108/107 in the intervention/control group) between September 2021 and September 2023. There were no differences between two groups in patient background characteristics including the prevalence of GA impairments. The number of conversations about aging-related concerns was significantly higher in the intervention group than in the control group (mean [SD] 2.95 [1.53] vs. 1.90 [1.49], p&lt;0.0001). The number of high-quality conversations and number of conversations about GAM recommendations were also significantly higher in the intervention group than in the control group (1.73 [1.40] vs. 1.12 [1.16], p=0.001; 0.57 [0.74] vs. 0.28 [0.47], p=0.001, respectively). Conclusions: Our program providing GAM recommendations and communication support successfully facilitated aging-related communications between patients and their oncologists. We will further examine whether facilitated communication leads to actual implementation of GAM and improved patient health outcomes in a follow-up study. Clinical trial information: UMIN000045428 .

Shared decision-making support program for older patients with advanced cancer using a question prompt list and geriatric assessment: A pilot randomized controlled trial

IntroductionOlder patients with cancer are less likely to express their treatment preferences than younger patients. Question prompt lists (QPLs) facilitate communication between patients and physicians. Geriatric assessment (GA) is recommended when older patients with cancer make treatment decisions. This study estimated the effect size of a shared decision-making (SDM) support program combining QPLs with GA in terms of patients' subjective evaluation of the SDM process for a future definitive randomized controlled trial. We also evaluated the number and quality of aging-related communication during consultations, and feasibility and acceptability of the study for exploratory purposes. Materials and MethodsThis is a pilot study with randomized allocation and blind evaluation. Patients aged 65 years or older at the National Cancer Center Hospital, Tokyo, Japan, scheduled to discuss the changes of their treatment, were randomly assigned in a 1:1 ratio to the SDM support program or usual care. This program consisted of 30–60 min of face-to-face coaching, with QPLs and GA provided before the coaching. As the primary endpoint, the decisional conflict scores given by the patients immediately after the consultation were compared between the two groups. For the secondary endpoints, the number and quality of aging-related communications during the consultations were assessed by evaluators (blinded) using audio-recordings. Adherence, burden, and usefulness were assessed for evaluating feasibility and acceptability of the SDM support program. ResultsForty patients were enrolled. All patients completed the GA questionnaire, for which 70% did not require any individual assistance. Answering the questionnaires took approximately 11 min. The decisional conflict scores were mean [standard deviation (SD)]: 19.3 [10.8] vs. 18.0 [11.1] (effect size: Cohen's d = 0.12) for the SDM support program and usual care groups, respectively. The number of aging-related communications during the consultation for the new treatment was higher in the SDM support program group than the usual care (mean [SD]: 3.3 [1.2] vs. 2.2 [1.5], effect size: cohen's d = 1.32). Patients felt that the SDM support program was useful but not burdensome or difficult. DiscussionThe SDM support program was considered useful and feasible for older patients and able to facilitate communication regarding aging-related concerns. Trial registration numberThe study protocol was registered on September 23, 2020, in the UMIN Clinical Trials Registry (UMIN000041867).

Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis.

Enhanced communication in end-of-life care (EOL) improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. Question prompt list (QPL) has been shown to enhance physician-patient communication in patients with cancer, but there is a lack of systematic review and meta-analysis for those with advanced cancer. Enhanced communication in end-of-life care improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. To review the effectiveness of QPL intervention on physician-patient communication and health outcomes during consultation in patients with advanced cancer. CINAHL, Embase, Scopus, and PsycINFO databases were undertaken using inclusion criteria for relevant articles up to August 2021. Pooled standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool and modified Jadad scale to assess the quality of the studies. Seven RCTs with 1059 participants were included, of which six studies were eligible for the meta-analysis. The pooled meta-analysis results indicated that QPL in patients with advanced cancer had a significant positive effect on the total number of questions asked (SMD, 0.73; 95% CI, 0.28 to 1.18; I2 = 83%) and on the patients' expectations for the future (SMD, 0.67; 95% CI, 0.08 to 1.25; I2 = 88%). There were no significant improvements in health-related outcomes such as end of life, anxiety, and quality of life. Using QPL in advanced cancer consultations boosts patient questions which helps communication but not health-related indicators. Optimal results depend on full reading, but timing varies. Future research should examine the relationship between communication and health outcomes, including patient/physician behavior and social context.

Development and initial evaluation of the usefulness of a question prompt list to promote patients' level of information about work-related medical rehabilitation: a pilot study.

The purpose of this study was to develop a question prompt list (QPL) to support patients undergoing work-related medical rehabilitation in obtaining relevant information and to explore how patients and physicians rate the QPL regarding its usefulness, practicability, and perceived (additional) effort. An initial item pool was assessed by rehabilitation patients (N = 3) in cognitive interviews, rated by physicians and other health professionals (N = 11), and then further modified. The final QPL version (16 items) was used by patients (N = 36) in medical admission interviews in an inpatient medical rehabilitation facility and then evaluated. Physicians evaluated the QPL after each interview with a study participant (N = 6; k = 39 interviews). The QPL was used by 50% of patients who rated its usefulness and comprehensibility positively. Neither the need for information nor satisfaction with the information received was correlated with QPL use. The physicians' assessment showed a positive evaluation regarding the provision of information and structuring of the conversation, but also a higher perceived time expenditure. While initial testing of the QPL in work-related medical rehabilitation as a tool to support patient-provider communication generally showed a favorable evaluation by patients using it and physicians, future research should address its validity and effectiveness.

A Delphi Method for Development of a Barrett's Esophagus Question Prompt List as a Communication Tool for Optimal Patient-physician Communication.

The question prompt list content was derived through a modified Delphi process consisting of 3 rounds. In round 1, experts provided 5 answers to the prompts "What general questions should patients ask when given a new diagnosis of Barrett's esophagus" and "What questions do I not hear patients asking, but given my expertise, I believe they should be asking?" Questions were reviewed and categorized into themes. In round 2, experts rated questions on a 5-point Likert scale. In round 3, experts rerated questions modified or reduced after the previous rounds. Only questions rated as "essential" or "important" were included in Barrett's esophagus question prompt list (BE-QPL). To improve usability, questions were reduced to minimize redundancy and simplified to use language at an eighth-grade level (Fig. 1). Twenty-one esophageal medical and surgical experts participated in both rounds (91% males; median age 52 years). The expert panel comprised of 33% esophagologists, 24% foregut surgeons, and 24% advanced endoscopists, with a median of 15 years in clinical practice. Most (81%), worked in an academic tertiary referral hospital. In this 3-round Delphi technique, 220 questions were proposed in round 1, 122 (55.5%) were accepted into the BE-QPL and reduced down to 76 questions (round 2), and 67 questions (round 3). These 67 questions reached a Flesch Reading Ease of 68.8, interpreted as easily understood by 13 to 15 years olds. With multidisciplinary input, we have developed a physician-derived BE-QPL to optimize patient-physician communication. Future directions will seek patient feedback to distill the questions further to a smaller number and then assess their usability.

Development of a question prompt list for Indian cancer patients receiving radiation therapy treatment and their primary family caregivers.

We aimed to develop two question prompt lists (QPLs), one for Indian cancer patients undergoing radiation therapy and the second for their primary family caregivers. The study comprised three phases: (1) qualitative interviews with patients (n=65) and PFCs (n=39) to identify their information needs, queries and concerns regarding RT; (2) development of draft QPLs using conventional content analysis and translation into Hindi and Marathi using European Organisation Research and Treatment of Cancer guidelines; and, (3) A readability analysis, and acceptability study with patients (n=22), PFCs (n=26) and Radiation Oncology (RO) staff (n=20) exploring barriers to QPL implementation. Analysis in Phase I identified questions patients and PFCs asked or wanted to ask their physician. A list of 125 and 136 questions were generated for patients and PFCs, respectively. After five iterations, the draft QPLs were finalised, translated, and back-translated from English into Hindi and Marathi (Phase II). In Phase III, most patients and PFCs reported the QPLs were easy to read, they did not find it difficult to ask the questions, and the questions were not emotionally upsetting. Conversely, RO staff reported concerns that patients may find it difficult to discuss the questions with their physician. The study highlights the need to empower patients and PFCs to ask questions and for staff to feel comfortable answering them. Implementing physician-endorsed QPLs could achieve these aims.

Tradução e validação do instrumento Childhood Hearing Loss Question Prompt List for Parents para a língua portuguesa brasileira

ABSTRACT Purpose This study aimed to translate and validate the Childhood Hearing Loss Question Prompt List (CHLQPL) for Parents into Brazilian Portuguese, supporting communication between healthcare professionals and families of children with hearing loss in Brazil. Methods A methodological approach was employed, comprising the translation and cross-cultural adaptation of the instrument, followed by validation through an iterative process involving experts and the target audience. The translation was conducted by bilingual translators, with subsequent back-translation and review by an expert committee to ensure conceptual and cultural equivalence. Validation involved collecting and analyzing feedback from parents of children with hearing loss and audiologists, using the Content Validity Index (CVI) to assess the instrument’s appropriateness. Results The analysis indicated positive acceptance of the translated instrument, with most items achieving a CVI above the threshold of 0.78, reflecting the instrument’s relevance and comprehensibility in the Brazilian context. One specific item did not reach the desired CVI, highlighting the need for further revision to optimize clarity and relevance. Conclusion The translated and validated CHLQPL proved to be an effective tool for the Brazilian context, facilitating family-centered communication and involvement in pediatric auditory care. This study reinforces the importance of adapting and validating assessment instruments to reflect cultural and linguistic specificities, ensuring applicability and effectiveness in assistingfamilies of children with hearing loss.

Translation and validation of the Childhood Hearing Loss Question Prompt List for Parents into brazilian portuguese

RESUMO Objetivo traduzir e validar para o português brasileiro o instrumento Childhood Hearing Loss Question Prompt List for Parents, visando apoiar a comunicação entre profissionais de saúde e famílias de crianças com perda auditiva no Brasil. Métodos abordagem metodológica compreendendo a tradução e adaptação transcultural do instrumento, seguida de validação por meio de um processo iterativo que envolveu especialistas e o público-alvo. A tradução foi realizada por tradutores bilíngues, com subsequente retrotradução e revisão por um comitê de especialistas, para assegurar a equivalência conceitual e cultural. A validação envolveu a coleta e análise de feedback de pais de crianças com perda auditiva e profissionais fonoaudiólogos, utilizando o Índice de Validade de Conteúdo para avaliar a adequação do instrumento. Resultados a análise indicou aceitação positiva do instrumento traduzido, com a maioria dos itens atingindo Índice de Validade de Conteúdo acima do limiar de 0,78, refletindo a relevância e compreensibilidade do instrumento no contexto brasileiro. Um item específico não atingiu o índice desejado, destacando a necessidade de revisão adicional para otimizar a clareza e pertinência. Conclusão o Childhood Hearing Loss Question Prompt List for Parents traduzido e validado demonstrou ser uma ferramenta eficaz para o contexto brasileiro, facilitando a comunicação centrada na família e o envolvimento em cuidados auditivos pediátricos. Este estudo reforça a importância de adaptar e validar instrumentos de avaliação para refletir as especificidades culturais e linguísticas, assegurando a aplicabilidade e eficácia no atendimento às famílias de crianças com perda auditiva.

Co-design of a question prompt list about pregnancy and childbearing for women with polycystic kidney disease: an exploratory sequential mixed-methods study

BackgroundAlthough women with polycystic kidney disease (PKD) generally have healthy pregnancies and babies, pregnancy is associated with a greater risk of maternal complications and requires planning and management of their condition. Given these possible complications, routine communication about childbearing between women with PKD and their treating team is important. A question prompt list (QPL), a structured list of questions used by patients during consultations with healthcare providers, may be beneficial in assisting women with PKD to discuss their childbearing concerns with, and seek related information from, their treating team. The aims of this study were to co‐design a QPL about pregnancy and childbearing for women with PKD, and evaluate its comprehensibility, salience, and acceptability.MethodsAn exploratory sequential mixed‐methods study of women of reproductive age with PKD living in Australia, using an experience‐based co‐design approach with two phases. Women were recruited from a metropolitan public health service and via social media and invited to complete an anonymous online survey about the development of the PKD QPL (phase one) and participate in an online discussion group about its refinement (phase two).ResultsSixteen women completed the development survey and seven participated in the evaluation discussion group. Participants reported that women with PKD would value and use a QPL to prompt discussions with and seek further information about pregnancy and childbearing from their healthcare providers. Women identified four main topics for the QPL: ‘thinking about having a baby’, ‘pregnancy’, ‘my medications’ and ‘after my baby is born’. Within each section a series of questions was developed. Based on the findings, a QPL about pregnancy and childbearing for women with PKD was co-designed.ConclusionsWomen with PKD often find it difficult to access information and have discussions with their health care providers about pregnancy and childbearing. The PKD QPL co-designed in this study was perceived to be an acceptable tool which will, from the perspectives of participants, assist women with PKD to access information more easily about pregnancy, childbearing and PKD; ask more targeted questions of their treating team; and make informed childbearing decisions.

Developing a question prompt list for family caregivers concerning the progression and palliative care needs of nursing home residents living with dementia.

Communication around a palliative approach to dementia care often is problematic or occurs infrequently in nursing homes (NH). Question prompt lists (QPLs), are evidence-based lists designed to improve communication by facilitating discussions within a specific population. This study aimed to develop a QPL concerning the progression and palliative care needs of residents living with dementia. A mixed-methods design in 2 phases. In phase 1, potential questions for inclusion in the QPL were identified using interviews with NH care providers, palliative care clinicians and family caregivers. An international group of experts reviewed the QPL. In phase 2, NH care providers and family caregivers reviewed the QPL assessing the clarity, sensitivity, importance, and relevance of each item. From 127 initial questions, 30 questions were included in the first draft of the QPL. After review by experts, including family caregivers, the QPL was finalized with 38 questions covering eight content areas. Our study has developed a QPL for persons living with dementia in NHs and their caregivers to initiate conversations to clarify questions they may have regarding the progression of dementia, end of life care, and the NH environment. Further work is needed to evaluate its effectiveness and determine optimal use in clinical practice. This unique QPL is anticipated to facilitate discussions around dementia care, including self-care for family caregivers.

Home values and experiences navigation track (HomeVENT): Supporting decisions about pediatric home ventilation

To pilot feasibility and acceptability of HomeVENT, a systematic approach to family-clinician decision-making about pediatric home ventilation. Parents and clinicians of children facing home ventilation decisions were enrolled at 3 centers using a pre/post cohort design. Family interventions included: 1) a website describing the experiences of families who previously chose for and against home ventilation 2) a Question Prompt List (QPL); 3) in-depth interviews exploring home life and values. Clinician HomeVENT intervention included a structured team meeting reviewing treatment options in light of the family's home life and values. All participants were interviewed one month after the decision. We enrolled 30 families and 34 clinicians. Most Usual Care (14/15) but fewer Intervention (10/15) families elected for home ventilation. Families reported the website helped them consider different treatment options, the QPL promoted discussion within the family and with the team, and the interview helped them realize how home ventilation might change their daily life. Clinicians reported the team meeting helped clarify prognosis and prioritize treatment options. The HomeVENT pilot was feasible and acceptable. This systematic approach to pediatric home ventilation decisions prioritizes family values and is a novel method to increase the rigor of shared decision-making in a rushed clinical environment.

Pilot trial of an educational immunotherapy intervention for patients with advanced cancer.

307 Background: Immune checkpoint inhibitors (ICIs) are first-line therapy for several cancers and have novel toxicities that are important for patients to understand. We developed UPLIFT (Understanding and Preparing for Life on Immunotherapy), an educational intervention for adults with advanced cancer initiating ICIs. We aimed to test the feasibility, acceptability, and preliminary efficacy of UPLIFT on immunotherapy knowledge and anxiety. Methods: We conducted a pilot randomized controlled trial (NCT04670445) of 130 adults (age ≥18 years) who were initiating an ICI for advanced (stage IV or unresectable stage III) cancer to compare UPLIFT, an educational video and question prompt list (QPL) intervention to promote discussion about risks and benefits of ICIs, versus usual care. Participants were randomized 1:1 to receive UPLIFT prior to ICI initiation (intervention) or after 6 weeks (control). Participants were administered surveys at enrollment (baseline), within 72 hours after their oncology visit on ICI initiation date (72h), and 6 weeks post-ICI initiation. The primary outcome was feasibility, defined as 70% enrollment among approached patients and 80% having watched the video and reviewed the QPL. We also assessed acceptability of UPLIFT (3-item survey), immunotherapy knowledge (8-item survey, scored as % correct), and anxiety (State subscale of State and Trait Anxiety Index-Short Form). We used ANCOVA models, adjusted for age and baseline scores, to analyze knowledge and anxiety outcomes. Results: We approached 178 eligible patients and enrolled 130 patients in the trial (73%). 66 patients were randomized to receive UPLIFT and 65 to waitlist control. Patients (38% female, mean age=67 years) had diagnoses of advanced melanoma (40%), lung cancer (26%), renal cell carcinoma (8%), hepatocellular carcinoma (8%), or other cancers (18%). All 66 (100%) patients assigned to UPLIFT watched the video and received the QPL; 47% reported using the QPL during their oncology visit. 94% of patients in the intervention group reported they were “somewhat” or “very comfortable” with the video and QPL. Patients assigned to UPLIFT had improvements in immunotherapy knowledge from baseline to 72h relative to control patients (difference between adjusted mean % correct: 9% [95% CI: 3% to 16%]). The change in anxiety from baseline to 72h was not significantly different between the groups (0.6, 95% CI: -2.6 to 3.8). There were no differences between groups in the change in knowledge or anxiety scores from baseline to 6 weeks. Conclusions: A novel intervention to educate patients about the risks and benefits of ICIs not only was feasible to deliver and acceptable, but also improved immunotherapy knowledge relative to usual care among patients with advanced cancer, without increasing anxiety. A future study to evaluate the efficacy of UPLIFT is warranted. Clinical trial information: NCT04670445 .

S508 Modifying an Expert-Derived, Achalasia-Specific Question Prompt List (QPL) Communication Tool by Incorporating Patients’ Perspectives and Feedback

S508 Modifying an Expert-Derived, Achalasia-Specific Question Prompt List (QPL) Communication Tool by Incorporating Patients’ Perspectives and Feedback

Evaluation of a Question Prompt List on Treatment Decision-making Outcomes in Women Following Surgery for Breast Cancer: A Randomized Controlled Trial

Background: With advances in healthcare options for the medical management of breast cancer, treatment decision-making has become more complex. Objectives: Guided by self-efficacy theory, the study investigated the impact of a question prompt list (QPL) on decision-making outcomes among women with breast cancer in Iran who were post-surgery. Methods: A randomized controlled trial was conducted at a comprehensive cancer center in Tehran, Iran. Fifty patients were randomized to either a QPL with usual care (n = 25) or to a usual care (n = 25) condition. Data were collected pre- and post-treatment utilizing: 9-item Shared Decision-Making Questionnaire; Decision Self-efficacy Scale; and the Control Preferences Scale. Utilizing SPSS 26 software, descriptive, Shapiro-Wilk test, independent t-test, Fisher's Exact test, and Mann-Whitney U test were used. Results: No differences between the usual care and QPL groups on major study constructs were found (P &gt; 0.05). Conclusions: The QPL did not impact various decision-making outcomes among women with breast cancer post-surgery. Cross-cultural research is needed with larger samples to further examine the impact of decision aids such as QPL on decision-making outcomes for women with breast cancer.

Evaluation of a Novel Question Prompt List in Pediatric Surgical Oncology

IntroductionParents of children with cancer describe interactions with clinicians as emotionally distressing. Patient engagement in treatment discussions decreases decisional conflict and improves decision quality which may limit such distress. We have shown that parents prefer to engage surgeons by asking questions, but parents may not know what to ask. Question Prompt Lists (QPLs), structured lists of questions designed to help patients ask important questions, have not been studied in pediatric surgery. We developed a QPL designed to empower parents to ask meaningful questions during pediatric surgical oncology discussions. We conducted a mixed methods analysis to assess the acceptability, appropriateness, and feasibility of using the QPL. MethodsKey stakeholders at an academic children's hospital participated in focus groups to discuss the QPL. Focus groups were recorded and transcribed. Participants were surveyed regarding QPL acceptability, appropriateness, and feasibility. Thematic content analysis of transcripts was performed. ResultsFour parents, five nurses, five nurse practitioners, five oncologists, and four surgeons participated. Seven key themes were identified: (1) QPL as a tool of empowerment; (2) stick to the surgical details; (3) QPLs can impact discussion quality; (4) time consuming, but not overly disruptive; (5) parental emotion may impact QPL use; (6) provide QPLs prior to surgical consultation in both print and digital formats; and (7) expansion of QPLs to other disciplines. Over 70% of participants agreed that the QPL was acceptable, appropriate, and feasible. ConclusionsOur novel QPL is acceptable, appropriate, and feasible to use with parents of pediatric surgical oncology patients.

Patients' attitudes towards using a question prompt list in community pharmacies

ObjectiveTo explore patients’ usage rate and perceived usefulness and benefits of a question prompt list (QPL) when collecting prescribed medication in community pharmacies. MethodsData were collected in Swedish pharmacies using questionnaires and semi-structured interviews with patients. The Technology Acceptance Model (TAM) was used, and the outcomes were usage rate, factors impacting on use, and perceived ease of use, usefulness, and benefits of self-reported question-asking and self-perceived medication knowledge. Descriptive statistics and group comparisons were performed, and qualitative data were analyzed thematically with the TAM. ResultsOut of 145 patients filling out the questionnaire, 72 (50.0%) reported they had used the QPL. Patients with new prescriptions and non-native Swedish speakers used the QPL more often (p = 0.03; p = 0.009, respectively). The QPL was quick to read (86.3%) and easy to understand (91.4%). Forty percent stated that they asked more questions, and self-reported users scored higher on self-perceived medication knowledge. In the interviews (n = 14), the QPL was described as an eye-opener as to what one could ask the pharmacist. ConclusionsPatients were willing to use a QPL in community pharmacies. Practice implicationsA QPL in pharmacies might improve patients' engagement medication knowledge, as well as showcase the expertise of pharmacists.