P505 The effect of using a question prompt list in outpatient clinic consultations in a Dutch inflammatory bowel disease population
N. Peek-Kuijt*1, M. de Jong1, N. Srivastava2, R. Veenendaal1, P. Maljaars1, L. van Bodegom-Vos3, A. Linn4, A. van der Meulen-de Jong1
1Leiden University Medical Centre, Department of Gastroenterology and Hepatology, Leiden, Netherlands, 2Medical Centre Haaglanden, Department of Gastroenterology and Hepatology, The Hague, Netherlands, 3Leiden University Medical Centre, Department of Medical Decision Making, Leiden, Netherlands, 4University of Amsterdam, Amsterdam School of Communication Research (ASCoR), Amsterdam, Netherlands
Inflammatory bowel disease (IBD) is a complex chronic disease, and over time, many different decisions regarding treatment and surveillance must be made. As such, good communication between patients and caregivers is essential. However, this proves to be quite difficult for caregivers and patients, as caregivers do not always know exactly the kind or amount of information a patient wants, and patients do not dare ask questions or do not exactly know what questions they might ask. Studies in cancer patients have proved these discrepancies between the expectations in communication of patients and caregivers. Many interventions have been developed to improve communication between caregivers and patients. One of these methods is the use of a question prompt list (QPL), a structured list of questions for patients that they can possibly ask their doctor. We developed a QPL for our IBD population and implemented this in our outpatient clinic during the study period. This study aims to assess the effect of the QPL on self-efficacy and patient satisfaction after one patient contact and after serial use.
Consecutive outpatient IBD patients in 2 different hospitals (academic and non-academic) were assigned to standard consultations, or to standard consultations with a prior QPL. A linear regression analysis was performed, correcting for possible confounders (gender, age at diagnosis, disease duration and body mass index).
In total, 420 patients were included (206 controls and 214 QPL). Compared with controls, introducing the QPL had no effect on self-efficacy (p = 0.54) or patient satisfaction (p = 0.21). Age at diagnosis, gender and BMI had no effect on self-efficacy or patient satisfaction. Length of disease duration did prove to have a positive influence on self-efficacy (95% CI 0.001–0.06; p = 0.046) and patient satisfaction (95% CI 0.004–0.023; p = 0.004). Doctor satisfaction increased significantly (95% CI 0.08–0.44; p = 0.005) when a QPL was used in consultations. The majority of patients preferred to receive both positive and negative information right away (78.8% in controls, 73.5% in the QPL group).
The introduction of a QPL in one outpatient contact has shown to have no effect on self-efficacy and patient satisfaction, in contrast to disease duration, which proved to be of influence. Possibly a QPL can be useful in newly diagnosed patients. Long term results of serial use of the QPL is studied by our group. The use of QPLs in an outpatient setting can also create awareness for doctors. This in turn might stimulate them to proactively provide more patient-tailored information than they otherwise would, leading to an increased satisfaction of their own consultations.