Clinician-patient communication: evidence-based recommendations to guide practice in cancer

摘要

Goals of Work To develop recommendations for effective communication between cancer health care providers and patients, based on a systematic review of methods of clinician-patient communication that may impact patient outcomes associated with distress at critical points in the course of cancer care. Materials and Methods A systematic review of the literature was conducted and evidence-based recommendations to guide clinician-patient communication in cancer care were formulated. A formal external review was conducted to validate the relevance of these recommendations. Main Results Recommendations for communication in cancer care are presented, based on (1) guidelines from the Australian National Breast Cancer Centre and National Cancer Control Initiative, (2) an updated systematic review of the research evidence, and (3) a consensus by the Clinician-Patient Communications Working Panel of the Program in Evidence-Based Care of Cancer Care Ontario. The majority (87%) of respondents from the external review process agreed with the draft recommendations and approved of their use as a practice guideline (91%). A condensed version of the recommendations, including ten key points, was also created. Conclusions There is evidence to support general clinician-patient communication approaches, although the preferences of cancer patients regarding such communication exhibit individual and cultural variability. Recommendations are provided, based upon evidence, the consensus of an expert panel, and feedback from a survey of external practitioners. Evidence evaluating the role of decision aids and strategies to facilitate better communication is inconsistent, although they may be of value for some patients.