title: Barriers and facilitators to the implementation of audio-recordings and question prompt lists in cancer care consultations: A qualitative study.
abstract: Question prompt lists (QPLs) and consultation audio-recordings (CARs) are two communication strategies that can assist cancer patients in understanding and recalling information. We aimed to explore clinician and organisational barriers and facilitators to implementing QPLs and CARs into usual care.
  
  
  
  Semi-structured interviews with twenty clinicians and senior hospital administrators, recruited from four hospitals. Interviews were recorded, transcribed verbatim and thematic descriptive analysis was utilised.
  
  
  
  CARs and QPLs are to some degree already being initiated by patients but not embedded in usual care. Systematic use should be driven by patient preference. Successful implementation will depend on minimal burden to clinical environments and feedback about patient use. CARs concerns included: medico-legal issues, ability of the CAR to be shared beyond the consultation, and recording and storage logistics within existing medical record systems. QPLs issues included: applicability of the QPLs, ensuring patients who might benefit from QPL's are able to access them, and limited use when there are other existing communication strategies.
  
  
  
  While CARs and QPLs are beneficial for patients, there are important individual, system and medico-legal considerations regarding usual care.
  
  
  
  Identifying and addressing practical implications of CARs and QPLs prior to clinical implementation is essential.
authors.affiliation: Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia. Electronic address: Natasha.Moloczij@petermac.org.
authors.forename: Natasha
authors.initials: N
authors.lastname: Moloczij
authors.affiliation: Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
authors.forename: Mei
authors.initials: M
authors.lastname: Krishnasamy
authors.affiliation: School of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.affiliation: College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hack
authors.affiliation: Centre for Women's Mental Health, The Royal Women's Hospital, Melbourne, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Stafford
authors.affiliation: Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Jefford
authors.affiliation: Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Psychology, Swinburne University of Technology, Melbourne, Australia.
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010358:Patient Participation; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013637:Tape Recording / Q000706:statistics & numerical data*
keywords: Audio-recording; Cancer; Communication; Patient-centred care; Question prompt lists qualitative