A0188 - Patient Perspective and Feedback on a Dysphagia-Specific Question Prompt List (QPL) Communication Tool

Sudharshan Achalu, BA¹, Rani Berry, MD¹, George Triadafilopoulos, MD², Marcelo F. Vela, MD³, Edoardo Savarino, MD, PhD⁴, Sabine Roman, MD⁵, Roberto Penagini, MD⁶, Benson T. Massey, MD⁷, David A. Katzka, MD⁸, Peter Kahrilas, MD⁹, C. Prakash Gyawali, MD, MRCP¹⁰, Ronnie Fass, MD¹¹, John O. Clarke, MD¹, Albert Bredenoord, MD, PhD¹², Afrin N. Kamal, MD, MS^1
1Stanford University, Redwood City, CA; ²Stanford University School of Medicine, Redwood City, CA; ³Mayo Clinic, Scottsdale, AZ; ⁴University of Padua, Padua, Veneto, Italy; ⁵Lyon Est Medical School, Lyon, Auvergne, France; ⁶University of Milan, Milan, Lombardia, Italy; ⁷Medical College of Wisconsin, Milwaukee, WI; ⁸Columbia University, New York, NY; ⁹Northwestern University, Chicago, IL; ¹⁰Washington University in St. Louis, St. Louis, MO; ¹¹MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH; ¹²Amsterdam University Medical Center, Amsterdam, Utrecht, Netherlands

Introduction: Question prompt lists (QPLs) are structured sets of disease-specific questions intended for patient use, to encourage patients to ask questions and enhance patient-physician communication. Recently, a preliminary 44 dysphagia QPL was created by 11 esophageal experts through a modified Delphi process. Patients’ perspective and feedback on each question, however, has not been accounted for in this expert version. We aim to obtain and incorporate patients' perspective and feedback on our expert-derived dysphagia QPL.

Methods: A preliminary dysphagia QPL was modified through patient perspective and feedback. Consecutive patients with esophageal dysphagia followed at Stanford University Esophageal Clinic between November 2021 and June 2022 were recruited to assess the preliminary expert QPL version. After receiving the QPL in Qualtrics (Provo, UT), patients independently rated questions on a 5-point Likert scale, where 1= “should not be included,” 2= “unimportant,” 3= “don’t know/depends,” 4= “important,” and 5= “essential.” Questions were accepted for inclusion in the QPL with an a priori inter-agreement of ³ 80% ranking (range 4 to 5). At the end, patients were encouraged to propose additional questions to incorporate into the QPL by an open-ended question added to the survey.

Results: Seventeen patients (13 female, age range 28-79) with a symptom presentation of esophageal dysphagia (Figure 1) assessed the existing QPL. Of the 44 questions experts agreed were important, only 30 questions (68.2%) were accepted for inclusion. Patients disagreed on the importance of questions such as “Do you think I have cancer?”, “Why do I cough or choke when I try to eat or drink?”, and “What can I do to avoid losing weight?” (Table 1). In contrast, patients highly agreed on the importance of the question “What are treatment options if symptoms do not go away?” Six patients suggested additional questions such as “Do cold liquids make swallowing worse?” By incorporating the suggested questions, the final dysphagia QPL totaled to 50 questions.

Discussion: With expert input followed by patient feedback, we have developed a patient-centered dysphagia QPL aimed to enhance patient-physician communication. Our study highlights the importance of patient perspective and feedback in development of a patient-centric communication tool. Future directions will assess patient and physician usability, as well as rigorously test the efficacy of this QPL on patient outcomes.




Disclosures:


Sudharshan Achalu, BA¹, Rani Berry, MD¹, George Triadafilopoulos, MD², Marcelo F. Vela, MD³, Edoardo Savarino, MD, PhD⁴, Sabine Roman, MD⁵, Roberto Penagini, MD⁶, Benson T. Massey, MD⁷, David A. Katzka, MD⁸, Peter Kahrilas, MD⁹, C. Prakash Gyawali, MD, MRCP¹⁰, Ronnie Fass, MD¹¹, John O. Clarke, MD¹, Albert Bredenoord, MD, PhD¹², Afrin N. Kamal, MD, MS¹. A0188 - Patient Perspective and Feedback on a Dysphagia-Specific Question Prompt List (QPL) Communication Tool, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.