title: Using a question prompt list as a communication aid in advanced cancer care.
abstract: OBJECTIVE
  Oncologists and patients often avoid discussing prognosis, treatment failure, and end-of-life planning. Thus, many patients still overestimate their prognosis and possibility of cure, impairing decision making. We piloted a question prompt list (QPL) covering these issues to determine whether it would affect patient anxiety and how it would be used and received by new oncology patients.
  
  
  METHODS
  A one-page checklist of common questions surrounding cancer care, quality of life, and end of life was created from previous instruments. A total of 30 patients with advanced or metastatic head and neck cancer were recruited from outpatient clinics. Patients received the QPL before their initial consultation. Patient anxiety, satisfaction, and information/decision-making preferences were assessed using validated instruments. Patient opinions regarding the QPL were solicited through Likert-scale items.
  
  
  RESULTS
  During their visit, 27 patients (90%) used the QPL, but notably, none shared it directly with their oncologist. Most participants felt that the QPL was relevant and helpful (90%) and recommended that more physicians use this sort of list (90%) while disagreeing that the QPL made them feel anxious (80%). Generally, participants were highly satisfied with the consultation, and their anxiety decreased during the visit (P < .005).
  
  
  CONCLUSIONS
  A simple, one-page QPL addressing cancer treatment, prognosis, quality of life, and end-of-life issues was well received by new oncology patients and did not affect patient anxiety or physician workflow. Follow-up studies will determine whether use of the QPL increases knowledge, facilitates decision making, and improves advance-care planning.
authors.affiliation: Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Yeh
authors.affiliation: Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: M Jennifer
authors.initials: MJ
authors.lastname: Cheng
authors.affiliation: Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD tsmit136@jhmi.edu.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010817:Physician-Patient Relations; D013727:Terminal Care