Recording oncologic consultations may benefit incurable patients
MedWire News: Recording discussions between patients with incurable cancer and their families and healthcare providers is feasible and may ease the transition from curative to palliative care, a pilot study has shown.
The majority of cancer patients and their families felt that receiving a recording of the consultation was helpful, leading the researchers to call for larger studies to validate the approach.
The study, by Madeleen Uitdehaag (University Medical Center Utrecht, the Netherlands) and team, explored the feasibility and impact of providing recordings of oncologic consultations in the setting of a diagnosis of terminal cancer.
"The provided information could be a starting point to initiate discussions about the illness, its treatment and its implications," explain Uitdehaag et al writing in the European Journal of Oncology Nursing. "It has been shown that patients feel more empowered during subsequent consultations when they have listened to a recording of a previous consultation."
They recruited 17 patients with a new diagnosis of incurable esophageal or head and neck cancer and randomly assigned them to receive a compact disc (CD; n=10) or no CD (n=7) of their consultation in which the diagnosis was given and the decision to provide palliative (rather than curative) care was discussed.
There were no technical or procedural issues during the recordings, report Uitdehaag and colleagues, but two patients had difficulty playing the CDs at home and two patients said the sound quality was unsatisfactory. However, all patients were satisfied with the choice of voice recording as opposed to video recording.
When questioned 1 week after the consultation, 71% of patients in the CD group said they felt that receiving the CD was "highly important" and, at 1 month, 75% said they would recommend the CD to other patients in the same situation.
Of the patients in the control (no CD) group, all but two said they would have liked to have received a recording of their consultation.
Within the first month after consultation, 80% of patients in the CD group had listened to the recording, most often accompanied by their spouses, and all CDs were listened to by people other than the patient themselves (including by spouses, children, friends, and general practitioners).
One month after the consultation, four patients said that they expected to listen to the CD again in the future.
Receiving the CD had a limited impact on patient outcomes, however, and mean quality-of-life scores were actually worse on nine out of 17 items in the CD group compared with the no-CD group at 1 month. Despite this, patients who received a CD reported greater openness to discuss cancer-related topics within the family at all timepoints.
Uitdehaag and co-authors note that it will be important to identify subgroups of patients who are most likely to benefit from the intervention, and conclude: "A large randomized study investigating the actual effects on quality-of life-issues of patients and their relatives is needed to gain more generalized results.
"A qualitative component could add strength to a large study also addressing the reasons why patients rated the provision of the CD differently."
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By Joanna Lyford