Development of a Question Prompt Sheet for Cancer Patients Receiving Outpatient Palliative Care

Background: A question prompt sheet (QPS) is a structured list of potential questions available for patients to ask their doctor during a clinical encounter. Although it has been shown to improve physician-patient interaction during clinical consultations, there is paucity of data on its use in the palliative care setting. The aim of this study was to develop a single-page consensus list of prompt questions for use by patients attending outpatient palliative care. Method: An expert group of experienced physicians and mid-level providers were invited to participate in the study conducted in three Delphi rounds. A consensus in this study was defined a priori as an agreement (i.e., agree or strongly agree) by a minimum of 80% of the experts. Results: One hundred percent of the 22 invited experts participated in all the three Delphi rounds of the study. The top 25 questions with the highest level of endorsement were chosen and used toward the development of the QPS. Twenty-eight percent of the questions were about symptoms, treatment, and lifestyle, 24% were about commonly asked questions by caregivers, 20% were regarding end-of-life issues, 16% were regarding the nature of the palliative care service, and 12% were regarding the type of available support. Conclusion: A 25-item, single-page QPS was developed for use by patients attending outpatient palliative care. Further studies are needed to determine its clinical effectiveness in assisting physician-patient communication.