Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/9813
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: How do doctors refer to patient-reported outcome measures (PROMS) in oncology consultations?
Authors: Greenhalgh, Joanne
Abhyankar, Purva
McCluskey, Serena
Takeuchi, Elena
Velikova, Galina
Contact Email: purva.abhyankar@stir.ac.uk
Keywords: Patient-reported outcome measures
Consultation
Qualitative
Oncology
Conversation analysis
Issue Date: Jun-2013
Publisher: Springer Verlag for the International Society of Quality of Life Research
Citation: Greenhalgh J, Abhyankar P, McCluskey S, Takeuchi E & Velikova G (2013) How do doctors refer to patient-reported outcome measures (PROMS) in oncology consultations?, Quality of Life Research, 22 (5), pp. 939-950.
Abstract: Purpose: We conducted a secondary qualitative analysis of consultations between oncologists and their patients to explore how patient-reported outcome measures (PROMs) data were referred to in the process of (1) eliciting and exploring patients' concerns; (2) making decisions about supportive treatment and (3) making decisions about chemotherapy and other systemic treatments. Methods: We purposively sampled audio recordings of 18 consultations from the intervention arm and 4 from the attention control arm of a previous UK randomised controlled trial of the feedback of PROMs data to doctors (Velikova et al. in J Clin Oncol 22(4):714-724 [1]). We used a combination of content and conversation analysis to examine how opportunities for discussion of health-related quality of life issues are opened up or closed down within the consultation and explore why this may or may not lead to changes in patient management. Findings: Explicit reference to the PROMs data provided an opportunity for the patient to clarify and further elaborate on the side effects of chemotherapy. High scores on the PROMs data were not explored further if the patient indicated they were not a problem or were not related to the cancer or chemotherapy. Symptomatic treatment was more often offered for problems like nausea, constipation, pain and depression but much less so for fatigue. Doctors discussed fatigue by providing a cause for the fatigue (e.g. the chemotherapy), presenting this as ‘something to be expected', minimising its impact or moving on to another topic. Chemotherapy regimens were not changed on the basis of the PROMs data alone, but PROMs data were sometimes used to legitimise changes. Conclusions: Explicit mention of PROMs data in the consultation may strengthen opportunities for patients to elaborate on their problems, but doctors may not always know how to do this. Our findings have informed the development of a training package to enable doctors to optimise their use of PROMs data within the consultation.
Type: Journal Article
URI: http://hdl.handle.net/1893/9813
DOI Link: http://dx.doi.org/10.1007/s11136-012-0218-3
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: University of Leeds
NMAHP Research
University of Huddersfield
St James University Hospital
St James University Hospital

Files in This Item:
File Description SizeFormat 
How do doctors refer to patient-reported outcome measures (PROMS) in oncology consultations.pdf2.07 MBAdobe PDFUnder Embargo until 31/12/2999     Request a copy

Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependant on the depositor still being contactable at their original email address.

This item is protected by original copyright



Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.