Question Prompts May Guide Deeper Patient-Provider Communication

Healthcare providers looking to deepen meaningful patient-provider communication may consider prompting their patients to ask them questions, a new JAMA Network Open study indicated.

The study, which looked particularly at cancer patients receiving supportive care and palliative care, showed that patients find a list of question prompts more useful for generating a meaningful conversation with their providers than just getting health information.

Said otherwise, patients don’t always know what they don’t know, so prompting them about which questions to ask may be more useful to them than simply issuing patient education materials (although general information sheets are also viewed favorably by patients, the study said).

These findings come as healthcare providers work to determine how to make patient education more accessible and improve the quality of patient-provider communication. An informed patient is an engaged patient, most experts agree, so it is crucial that health communications are deep and meaningful and help patients truly understand their disease and course of treatment.

Healthcare providers may be able to achieve that deep patient-provider communication by enlisting the help of a question prompt sheet (PQS), a structured list of potential questions a patient could ask during a clinical encounter.

“This is vital because patients sometimes are unsure about the questions to ask their physicians, forget to ask the relevant questions, or feel uncomfortable to ask certain questions,” the researchers, who hailed from the University of Texas MD Anderson Cancer Center, explained.

The study focused particularly on cancer patients receiving palliative care or supportive care medicine, a population for which research into PQS is scant, the report authors said.

A total of 130 patients participated and received either a PQS with 25 questions about palliative and supportive care or a general information sheet (GIS), which providers routinely hand out to patients in the supportive care clinic.

On the whole, patients found both the PQS and the GIS equally useful, but if they had to choose just one, they’d pick the PQS. The PQS received an overall higher global positive view score than the GIS, getting a 7.1 out of 10 compared to 6.5 for the GIS. Patients also said the PQS prompted them to ask more questions compared to the GIS, getting a 7 compared to a 5.3 for the GIS.

The researchers pointed out that this simply reflects patient perceptions; patients perceived themselves as asking new questions of their providers after using the PQS. However, patients getting the PQS did not actually ask more questions than those getting the GIS. The researchers indicated this perception may indicate overall more meaningful questions during patient-provider communication.

“The QPS may effectively improve communication quality without necessarily increasing the number of questions that patients ask,” they explained. “In that regard, patient self-report of the helpfulness of the material might be a highly reliable indicator of benefit from the information material.”

All said, patients said they’d prefer to use the PQS to aid their patient-provider communications rather than the GIS. Notably, the PQS did not ignite patient anxiety by bringing to light questions a patient may not have thought of. That’s counter to some provider apprehensions, the researchers noted.

“This should reassure health care practitioners who may be concerned that the QPS questions will be emotionally upsetting and negatively impact patients’ psychological outcomes,” they stated.

And it’s not just that patients like the PQS; the study showed that it’s a viable addition to the clinical encounter. For one thing, it doesn’t increase the amount of time spent during appointments, which is key for overworked providers trying to stay on top of appointment wait times.

Patient-provider communication is an important aspect of any type of healthcare, as it helps inform patients about their care, mitigate fears, and build rapport and trust between the patient and the provider. And in palliative care and supportive care medicine, communication has the added element of even guiding care plans.

Because these types of medicine prioritize shared decision-making and patient preferences, being able to facilitate deep and meaningful conversations between patient and provider is critical to good outcomes, quality of life, and positive patient experiences.