Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug:113:107764.
doi: 10.1016/j.pec.2023.107764. Epub 2023 Apr 18.

"It helps us say what's important..." Developing Serious Illness Topics: A clinical visit agenda-setting tool

Catherine H Saunders  1 , Marie-Anne Durand  2 , Peter Scalia  3 , Kathryn B Kirkland  4 , Meredith A MacMartin  4 , Amber E Barnato  2 , David Wilson Milne  5 , Joan Collison  5 , Ashleigh Bennett  6 , Garrett Wasp  4 , Eugene Nelson  2 , Glyn Elwyn  2
Affiliations
Review

"It helps us say what's important..." Developing Serious Illness Topics: A clinical visit agenda-setting tool

Catherine H Saunders et al. Patient Educ Couns. 2023 Aug.

Abstract

Background: Skillful communication with attention to patient and care partner priorities can help people with serious illnesses. Few patient-facing agenda-setting tools exist to facilitate such communication.

Objective: To develop a tool to facilitate prioritization of patient and care partner concerns during serious illness visits.

Patient or family involvement: Two family members of seriously ill individuals advised.

Methods: We performed a literature review and developed a prototype agenda-setting tool. We modified the tool based on cognitive interviews with patients, families and clinicians. We piloted the tool with patients, care partners and clinicians to gain an initial impression of its perceived value.

Results: Interviews with eight patients, eight care partners and seven clinicians, resulted in refinements to the initial tool, including supplementation with visual cues. In the pilot test, seven clinicians used the tool with 11 patients and 12 family members. Qualitatively, patients and care partners reported the guide helped them consider and assert their priorities. Clinicians reported the tool complemented usual practice. Most participants reported no distress, disruption or confusion.

Discussion: Patients, care partners and clinicians appreciated centering patient priorities in serious illness visits using the agenda-setting tool. More thorough evaluation is required.

Practical value: The agenda-setting tool may operationalize elements of good serious illness care.

Keywords: Agenda-setting; Communication training; Consultation tool; Palliative care; Serious illness.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Development of this manuscript was supported, in part, by the T32 Research Fellowship in Geriatric Mental Health Services Research (T32 MH19132; Bruce).Dr. Scalia has nothing to disclose. Ms. Collison has nothing to disclose. Mr. Wilson Milne has nothing to disclose. Dr. MacMartin has nothing to disclose. Dr. Barnato has nothing to disclose. Ms. Butt has nothing to disclose. Dr. Wasp has nothing to disclose. Dr. Saunders reports holding copyright in The Considerate Suite. Dr. Durand reports fees from EBSCO Health and ACCESS Community Health Network and reports holding copyright in The Considerate Suite. Dr. Nelson reports stocks in Quality Data Management, Inc. Dr. Elwyn reports royalties from Oxford University Press and Radcliffe Press, ownership of &think LLC, SHARPNetwork LLC, and fees from ACCESS Community Health Network, Chicago Federally Qualified Medical Centers, EBSCO Health, Bind Insurance, PatientWisdom Inc, abridge AI Inc. He also reports holding copyright in The Considerate Suite.

References

    1. Singer AE, Meeker D, Teno JM, Lynn J, Lunney JR, Lorenz KA Symptom trends in the last year of life from 1998 to 2010: a cohort study Ann Intern Med, 162 (2015), pp. 175–183, 10.7326/M13-1609 - DOI - PMC - PubMed
    1. Dzul-Church V, Cimino JW, Adler SR, Wong P, Anderson WG “I’m sitting here by myself.”: experiences of patients with serious illness at an Urban Public Hospital J Palliat Med, 13 (2010), pp. 695–701, 10.1089/jpm.2009.0352 - DOI - PMC - PubMed
    1. Gilligan T, Coyle N, Frankel RM, Berry DL, Bohlke K, Epstein RM, et al. Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline J Clin Oncol, 35 (2017), pp. 3618–3632, 10.1200/JCO.2017.75.2311 - DOI - PubMed
    1. Mo L, Urbauer DL, Bruera E, Hui D Recommendations for Palliative and Hospice Care in NCCN Guidelines for Treatment of Cancer Oncologist, 26 (2021), pp. 77–83, 10.1002/ONCO.13515 - DOI - PMC - PubMed
    1. Mack JW, Cronin A, Taback N, Huskamp HA, Keating NL, Malin JL, et al. End-of-life care discussions among patients with advanced cancer: a cohort study Ann Intern Med, 156 (2012), pp. 204–210, 10.7326/0003-4819-156-3-201202070-00008 - DOI - PMC - PubMed

Publication types

LinkOut - more resources