Helping Patients Understand

Recommendations for simplifying patient conversations about cancer

(RxWiki News) Combine fear with a basic lack of understanding about cancer. Add in lots of facts and figures. And what you have is a patient who is confused and often unable to make good decisions as a result.

There are so many things for oncologists to discuss with their patients. From describing the cancer itself and talking about various therapies, to going over what the future may hold in terms of risk factors and survival statistics, the language and the subject matter are complex.

"Keep asking questions until you understand."

Angela Fagerlin, Ph.D., of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan and the VA Ann Arbor Center for Clinical Management Research worked with colleagues to develop recommendations to help doctors help their patients understand more.

The problem involves the fact that patients often lack the "health literacy" to understand what their doctors are saying. In addition, patients may not be able to decipher the statistics relating to risk and benefits.

Here are some of the guidelines for improving patient communications offered physicians:

  • Use plain language.
  • Talk only about what patients need to know.
  • Save the most important information for the last to help patients remember.
  • Discuss absolute risks - that is, the chance of getting a disease under different circumstances.
  • Avoid discussing relative risks, i.e., a "50 percent greater risk."
  • Explain the element of time such as a lifetime risk instead of a 10-year timeframe.

The authors say that making the information and the statistics clear helps patients choose the best course of treatment for them.

For example, they point out, if relative risk figures are used, then the reduction of risk will appear larger so that treatments are viewed in a more favorable light.

The recommendations were published in a commentary that appeared September 19, 2011 in the Journal of the National Cancer Institute.

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Review Date: 
September 19, 2011