Knowledge Bank

Effective communication between doctors and patients has been shown to lead to increased patient satisfaction (Stiles, 1979; Treadway, 1983), better adherence to medical recommendations (Cegala, 2000), and enhanced health outcomes (Stewart, 1999). This study tested the feasibility and effectiveness of a patient-centered communication system designed to improve communication between women undergoing chemotherapy treatment for breast cancer and their physicians. Fifty women at one of two study sites were recruited for the study and randomized into either the intervention or control arms. Baseline and post-treatment data were collected for both groups, but only the intervention participants utilized the intervention tool during treatment. Intervention participants were asked use a PDA to complete weekly symptom profiles assessing pain, fatigue, and depression and watch communication skills training videos tailored to symptom severity and race prior to each medical visit. If scores on an inventory crossed a high severity threshold, an alarm message would pop up on the PDA requesting that the patient contact her physician’s office to discuss the problematic symptom. The PDA recorded the overall symptom scores, the frequency of alarm triggering, and the frequency of video activation. Participants’ medical charts were also reviewed for details concerning each treatment and medical visit. Results showed that the frequency of depression video clicks was significantly associated with increased discussion about depression. The number of alarm triggers significantly influenced the occurrence of both a discussion of depression and a behavioral recommendation from the physician to the patient about her depression. In addition, the overall depression sum was a reliable predictor of the physician making a behavioral recommendation for treatment of the patient’s depression symptoms. Overall, the use of the intervention tool showed the ability to increase communication concerning chemotherapy-related depression symptoms between breast cancer patients and their physicians and has promising potential in overcoming barriers in patient-physician communication.