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Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis

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Abstract

Background

Enhanced communication in end-of-life care (EOL) improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. Question prompt list (QPL) has been shown to enhance physician–patient communication in patients with cancer, but there is a lack of systematic review and meta-analysis for those with advanced cancer. Enhanced communication in end-of-life care improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life.

Objective

To review the effectiveness of QPL intervention on physician–patient communication and health outcomes during consultation in patients with advanced cancer.

Methods

CINAHL, Embase, Scopus, and PsycINFO databases were undertaken using inclusion criteria for relevant articles up to August 2021. Pooled standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool and modified Jadad scale to assess the quality of the studies.

Results

Seven RCTs with 1059 participants were included, of which six studies were eligible for the meta-analysis. The pooled meta-analysis results indicated that QPL in patients with advanced cancer had a significant positive effect on the total number of questions asked (SMD, 0.73; 95% CI, 0.28 to 1.18; I2 = 83%) and on the patients’ expectations for the future (SMD, 0.67; 95% CI, 0.08 to 1.25; I2 = 88%). There were no significant improvements in health-related outcomes such as end of life, anxiety, and quality of life.

Conclusions

Using QPL in advanced cancer consultations boosts patient questions which helps communication but not health-related indicators. Optimal results depend on full reading, but timing varies. Future research should examine the relationship between communication and health outcomes, including patient/physician behavior and social context.

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Authors and Affiliations

  1. Nursing Department, Ren Ai Hospital, New Taipei City, Taiwan

    Shu-Jung Wang

  2. School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan

    Wen-Yu Hu

  3. Department of Nursing, National Taiwan University Hospital, Taipei City, Taiwan

    Wen-Yu Hu

  4. School of Nursing and Graduate Institute of Nursing, China Medical University, Beitun District, , 406, Taichung, Taiwan

    Yun-Chen Chang

  5. Nursing Department, China Medical University Hospital, Taichung, Taiwan

    Yun-Chen Chang

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Contributions

SJW, YCC, and WYH: study conception and design. SJW and YCC: data collection. All authors: data analysis and interpretation, drafting of the article, and critical revision of the article. All authors contributed to the article and approved the submitted version.

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Correspondence to Yun-Chen Chang.

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Wang, SJ., Hu, WY. & Chang, YC. Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis. Support Care Cancer 32, 231 (2024). https://doi.org/10.1007/s00520-024-08432-3

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