Manage Patient Expectations by Simplifying Communication, Strengthening Trust

New York—It is important to simplify discussions and facilitate open dialogues with patients when discussing their treatment expectations, according to Beth Eaby-Sandy, MSN, CRNP, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.

During her presentation at the 23rd Annual Perspectives in Thoracic Oncology meeting, Dr Eaby-Sandy discussed the best ways to manage patient expectations about treatment, and what to look out for.

Stressing the need for simplicity, she cited many studies in which it was shown that patients either do not entirely understand their treatment plan, misunderstood their diagnosis altogether, or had no idea about what certain frequently used terms meant.

“Facilitate discussions about treatment expectations by using certain phrases or validating concerns, "I hope... But I worry..." Facilitate a relationship with your patient and get to know them, feel comfortable having conversation,” she recommended.

“Discuss the chances that a therapy will work and the goal of that therapy, but never say PFS [progression-free survival], they don’t know what that means,” she added.

In addition, she brought up variances in patient preferences for decision making, and asked openly – do clinicians actually know what their patients understand?

Citing the media as a source for many unfulfilled or misunderstood expectations by patients, Dr Eaby-Sandy acknowledged that patients are often swayed by large cancer center marketing slogans, such as “The goal seems insurmountable….. We achieved it” or “Making cancer history.’

Aside from simplifying and enhancing communication with patients and their families, it is crucial that physicians encourage their patients to seek out the support of other patients, and support groups in general. She even noted a tendency for patients to like online support groups over live, in-person support sessions, mostly because of barriers such as time, distance, attitude, and personal needs.

Dr Eaby-Sandy also touched upon the sensitive subject of end-of-life discussions. Interestingly, the issues surrounding this type of discourse primarily had to do with clinician perception.

“The major barrier of poor prognosis communication is the stress and pain suffered by the physician,” she said, adding that, contrary to popular belief, discussions about end-of-life are not being depressing, do not reduce patient survival, and do not take away hope from the patient.

In addition to recommending simplified discussions and a need to better understand the patient perspective, Dr Eaby-Sandy provided some tips for how to prepare for discussing these topics with patients, based on guidelines from the American Society of Clinical Oncology. These tips included comprehensively reviewing patient medical charts, exploring patient understanding first and foremost, and, perhaps most importantly, promoting a relationship built on trust and confidence with the patient.—Hina Khaliq