In a randomised trial investigating the effects of regular use of health-related quality
of life (HRQOL) in oncology practice, we previously reported an improvement in communication
(objective analysis of recorded encounters) and patient well-being. The secondary
aims of the trial were to measure any impact on patient satisfaction and patients'
perspectives on continuity and coordination of their care.
In a prospective trial involving 28 oncologists, 286 cancer patients were randomised
to: (1) intervention arm: regular touch-screen completion of HRQOL with feedback to
physicians; (2) attention-control arm: completion of HRQOL without feedback; and (3)
control arm: no HRQOL assessment. Secondary outcomes were patients' experience of
continuity of care (Medical Care Questionnaire, MCQ) including 'Communication', 'Coordination'
and 'Preferences to see usual doctor' subscales, patients' satisfaction, and patients'
and physicians' evaluation of the intervention. Analysis employed mixed-effects modelling,
multiple regression and descriptive statistics.
Patients in the intervention arm rated their continuity of care as better than the
control group for 'Communication' subscale (p=0.03). No significant effects were found
for 'Coordination' or 'Preferences to see usual doctor'. Patients' evaluation of the
intervention was positive. More patients in the intervention group rated the HRQOL
assessment as useful compared to the attention-control group (86% versus 29%), and
reported their doctors considered daily activities, emotions and quality of life.
Regular use of HRQOL measures in oncology practice brought changes to doctor-patient
communication of sufficient magnitude and importance to be reported by patients. HRQOL
data may improve care through facilitating rapport and building inter-personal relationships.
Copyright 2010 Elsevier Ltd. All rights reserved.