Clinicians' and patients' perspectives on discussing outcomes during healthcare visits - Qualitative study with dyadic interviews.

Abstract

We aimed to explore patients' and clinicians' perspectives on discussing different types of outcomes during healthcare visits: clinical outcomes, patient reported outcomes (PROs), calculated prognostic outcomes and comparisons of individual patient outcomes with aggregated data. Dyadic interviews (n = 22) with patients with breast cancer or chronic kidney disease and their treating clinician. Participants varied in their preference in what outcomes to discuss depending on: their emphasis on numerical data, perceived control over outcomes, patients' approach to uncertainty regarding the future, and the impact of outcomes on patient's motivation. Patients and clinicians agreed that avoiding information overload and enabling a trust-based patient-clinician relationship were important facilitators for discussing outcomes. The interviews revealed that assumptions from patients and clinicians about each other were not always correct. Discussion of these misassumptions led to new insights; patients realized their (non-medical) information is relevant to clinicians, and clinicians recognized they sometimes misjudge which outcomes patients wish to hear. We identified varying preferences in discussing different types of outcomes among both patients and clinicians. The dyadic interview method proved to be effective in revealing misassumptions. Interviews revealed adverse effects of discussing outcomes, highlighting the importance of open dialogue and exploring information needs rather than assuming them.