Head and neck oncology post-treatment consultations form a critical component of care in terms of support and surveillance. They occur frequently in the first few years and can place substantial demands on healthcare resources. However, they provide useful opportunities for patients to raise issues and receive tailored information and support. The aim of this paper was to assess whether completion of a 56-item patient prompt list (PCI - the Patient Concerns Inventory) immediately prior to the consultation significantly increased its duration. This was a pragmatic cluster preference randomised controlled trial of 288 patients with 15 consultant clusters from two sites “using” (n = 8) or “not using” (n = 7) the PCI. Consultation times were known for 283 patients (136 PCI, 147 non-PCI) who attended their first post-treatment trial consultation a median (IQR) of 103 (70-160) days after the end of treatment. Consultations lasted a median (IQR) of 10 (7-13) minutes (mean 11) in non-PCI patients and a median (IQR) of 11 (8-15) minutes (mean 12) in PCI patients (p = 0.07). After adjustment for patient clustering and significant case mix, the 95% confidence interval for the mean difference was between 1.45 minutes shorter with the PCI and 2.98 minutes longer (p = 0.50). There was significant variation in duration by consultant, tumour stage, treatment mode, overall quality of life (QoL), and distress (all p < 0.001). In those who completed the PCI, duration increased with the total number of items selected (p < 0.001). In conclusion, the inclusion of a prompt list to help facilitate conversation with patients did not make a substantial difference to consultation times.
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- Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma.Eur Arch Otorhinolaryngol. 2013; 270: 1981-1989
- Outpatient follow-up appointments for patients having curative treatment for cancer of the head and neck: are the current arrangements in need of change?.Br J Oral Maxillofac Surg. 2014; 52: 681-687
- Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines.J Laryngol Otol. 2016; 130: S208-S211
- Follow-up and survivorship in head and neck cancer.Clin Oncol (R Coll Radiol). 2016; 28: 451-458
- Head and neck cancer survivorship care: a review of the current guidelines and remaining unmet needs.Curr Treat Options Oncol. 2018; 19: 44
- Issues patients would like to discuss at their review consultation: variation by early and late stage oral, oropharyngeal and laryngeal subsites.Eur Arch Otorhinolaryngol. 2013; 270: 1067-1074
- An evaluation of the Head and Neck Cancer Patient Concerns Inventory across the Merseyside and Cheshire Network.Br J Oral Maxillofac Surg. 2014; 52: 615-623
- Patients’ reports of barriers to expressing concerns during cancer consultations.Patient Educ Couns. 2015; 98: 317-322
- Uncovering patients’ concerns in routine head and neck oncology follow up clinics: an exploratory study.Br J Oral Maxillofac Surg. 2013; 51: 294-300
- Patients concerns inventory highlights perceived needs and concerns in head and neck cancer survivors and its impact on health-related quality of life.Br J Oral Maxillofac Surg. 2015; 53: 371-379
- The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic.Oral Oncol. 2009; 45: 555-561
- Content comparison of unmet needs self-report measures used in patients with head and neck cancer: a systematic review.Psychooncology. 2019; 28: 2295-2306
- A national survey of healthcare professionals’ views on models of follow-up, holistic needs assessment and survivorship care for patients with head and neck cancer.Eur J Cancer Care (Engl). 2015; 24: 873-883
- Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: a cluster preference randomized controlled trial.BMC Cancer. 2018; 18: 444
- Recruitment, response rates and characteristics of 5511 people enrolled in a prospective clinical cohort study: head and neck 5000.Clin Otolaryngol. 2016; 41: 804-809
- The addition of mood and anxiety domains to the University of Washington quality of life scale.Head Neck. 2002; 24: 521-529
- Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients.Psychooncology. 2008; 17: 556-560
EQ-5D. Available from URL: https://euroqol.org/ (last accessed 18 August 2020).
- The physical function and social-emotional function subscales of the University of Washington Quality of Life Questionnaire.Arch Otolaryngol Head Neck Surg. 2010; 136: 352-357
- Screening for dysfunction to promote multidisciplinary intervention by using the University of Washington Quality of Life Questionnaire.Arch Otolaryngol Head Neck Surg. 2009; 135: 369-375
- Reducing patients’ unmet concerns in primary care: the difference one word can make.J Gen Intern Med. 2007; 22: 1429-1433
- Development and evaluation of a holistic surgical head and neck cancer post-treatment follow-up clinic using touchscreen technology-feasibility study.Eur J Cancer Care (Engl). 2018; 27e12809
- Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world.Head Neck. 2020; 42: 498-512
Published online: September 11, 2020
Accepted: August 11, 2020
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.