First impressions: A prospective evaluation of patient–physician concordance and satisfaction following the initial medical oncology consultation

• Published in: Cancer medicine (Malden, MA) Vol. 12; no. 24; pp. 22293 - 22303
• Main Authors: Bach, Yvonne, Panov, Elan, Espin‐Garcia, Osvaldo, Chen, Eric, Krzyzanowska, Monika, O'Kane, Grainne, Moore, Malcolm, Prince, Rebecca M., Knox, Jennifer, Grant, Robert, Ma, Lucy X., Allen, Michael J., Eng, Lawson, Kosyachkova, Ekaterina, Megid, Thais Baccili Cury, Barron, Carly, Wang, Xin, Saltiel, Marie‐Philippe, Farooq, Abdul Rehman Rehman, Jang, Raymond W., Elimova, Elena
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.12.2023; John Wiley and Sons Inc; Wiley
• Subjects: Cancer therapies; Caregivers; Chemotherapy; Communication; Decision making; Demographics; Diagnosis; Gastrointestinal neoplasms; Malignancy; Medical diagnosis; medical oncology; Oncology; patient communication; Patient satisfaction; Patients; Performance evaluation; Physicians; Prognosis; psycho‐oncology; Questionnaires; Radiation; Regression analysis; Statistical analysis; Variables; medical oncology; patient communication; Gastrointestinal neoplasms; prognosis; psycho-oncology
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.6758

Background An especially significant event in the patient–oncologist relationship is the initial consultation, where many complex topics—diagnosis, treatment intent, and often, prognosis—are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. Methods Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper‐based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient–physician responses were compared to assess the degree of concordance. Results A total of 184 matched patient–physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). Conclusion An in‐depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer. This study aimed to measure gastrointestinal cancer patients' understanding of the information discussed and their satisfaction with the communication during their first medical oncology visit. We found that patient–physician concordance rates were low in treatment intent (palliative vs. curative intent) and prognosis.