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. 2019 Jul 29:11:520-528.
doi: 10.1016/j.dadm.2019.06.001. eCollection 2019 Dec.

Clinician-patient communication during the diagnostic workup: The ABIDE project

Leonie N C Visser  1   2 , Marleen Kunneman  3   4 , Laxsini Murugesu  1 , Ingrid van Maurik  2   5 , Marissa Zwan  2 , Femke H Bouwman  2 , Jacqueline Schuur  6 , Hilje A Wind  7 , Marjolijn S J Blaauw  8 , J Jolijn Kragt  9 , Gerwin Roks  10 , Leo Boelaarts  11 , Annemieke C Schipper  12 , Niki Schooneboom  13 , Philip Scheltens  2 , Wiesje M van der Flier  2   5 , Ellen M A Smets  1
Affiliations

Clinician-patient communication during the diagnostic workup: The ABIDE project

Leonie N C Visser et al. Alzheimers Dement (Amst). .

Abstract

Introduction: We aimed to describe clinician-patient communication in the diagnostic process of memory clinics, specifically clinician behavior known to facilitate knowledgeable participation of patients during consultations.

Methods: In this multicenter, observational study, we audio-recorded routine diagnostic consultations of 41 clinicians and 136 patients/caregivers at eight memory clinics. Patients/caregivers completed surveys after each audiotaped consultation. We used a study-specific coding scheme to categorize communication behavior.

Results: Clinicians often provided information on (results of) diagnostic testing. They infrequently invited questions and/or checked understanding. Clinician behavior to involve patients in decision-making about diagnostic testing was limited. Of note, patients/caregivers rarely expressed their information or involvement preferences. Yet, approximately, one quarter of them would have liked to receive more information.

Discussion: Involving patients more explicitly by means of shared decision-making could benefit the quality of care provided in memory clinics because it enables clinicians to attune the diagnostic workup to the individual patient's needs.

Keywords: Alzheimer's disease; Dementia; Diagnostic work-up; Doctor-patient communication; Patient engagement; Shared decision-making.

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Figures

Fig. 1
Fig. 1
Flowchart of study procedures. Notes. Pretesting consultations took place mostly before (potential) diagnostic testing. Because of variation in diagnostic pathways between memory clinics , testing was occasionally scheduled before, yet on the same day as, the first consultation with the clinician. To be still considered pretesting, no test results had to be disclosed. For 43% of patients, more than one pretesting consultation was audiotaped, for example, because patients met with a resident first and later with the supervising clinician. During analyses, we considered these multiple pretesting consultations per patient to be one.
See this image and copyright information in PMC

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