Cancer Medicine (Dec 2023)

First impressions: A prospective evaluation of patient–physician concordance and satisfaction following the initial medical oncology consultation

  • Yvonne Bach,
  • Elan Panov,
  • Osvaldo Espin‐Garcia,
  • Eric Chen,
  • Monika Krzyzanowska,
  • Grainne O'Kane,
  • Malcolm Moore,
  • Rebecca M. Prince,
  • Jennifer Knox,
  • Robert Grant,
  • Lucy X. Ma,
  • Michael J. Allen,
  • Lawson Eng,
  • Ekaterina Kosyachkova,
  • Thais Baccili Cury Megid,
  • Carly Barron,
  • Xin Wang,
  • Marie‐Philippe Saltiel,
  • Abdul Rehman Rehman Farooq,
  • Raymond W. Jang,
  • Elena Elimova

DOI
https://doi.org/10.1002/cam4.6758
Journal volume & issue
Vol. 12, no. 24
pp. 22293 – 22303

Abstract

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Abstract Background An especially significant event in the patient–oncologist relationship is the initial consultation, where many complex topics—diagnosis, treatment intent, and often, prognosis—are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. Methods Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper‐based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient–physician responses were compared to assess the degree of concordance. Results A total of 184 matched patient–physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). Conclusion An in‐depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer.

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