Facilitating patient-oncologist communication in advanced treatment-resistant cancer: development and feasibility testing of a question prompt list.

Abstract Background Patients' expectations regarding medical information in advanced stages of cancer are still poorly understood in France. Tailoring information to advanced cancer patients is a subtle task. We have developed a question prompt list (QPL), serving as a patient-oncologist communication aid. Methods A four-step sequential mixed-method was followed, involving patients with luminal B/triple-negative metastatic breast cancer or metastatic uveal melanoma (N = 110), patients’ partners, oncologists and researchers (N = 18). In-depth interviews and questionnaires focused on information needed at disclosure of metastasis or resistance to treatment (step 1), formulation of questions and procedures for use in oncology visits (steps 2 and 3), and acceptability of final tool (stage 4). Results The QPL initial version consists of 17 questions covering 5 themes (disease, current treatment, other options, living with cancer, prognosis). In step 2, 13 questions were added, 2 merged and 5 deleted; a short form (4 questions) and recommendations for clinical use were proposed. At step 3, 2 questions were merged and 6 deleted. Four oncologists (27% of the target population) took part in step 4, and the QPL was discussed with 20 patients, revealing a positive appraisal. Conclusion We provide a rigorously developed, relevant, concise and acceptable question prompt list for clinical application in the advanced cancer care setting in France. Further research needs to assess whether this tool actually facilitates the oncologist-patient communication and improves satisfaction with care and health outcomes. Trial registration: The study is listed in ClinicalTrials.gov (NCT04118062) and registered under identification n° IRRID ‘International Registered Report Identifier’: DERR1-10.2196/26414.