Abstract
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.
Keywords
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Article info
Publication history
Published online: September 11, 2020
Accepted:
August 11,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
