PRO-based clinical communication
Contextualisation of PRO data (2): Video example
Example: Louis Brown
Are you already familiar with Louis from Chapter 7?
If not: Louis is 29 years old and has been diagnosed with advanced Morbus Hodgkin. He has completed his first cycle of chemotherapy. The second cycle is being given in an outpatient setting.
At his first clinic visit after starting chemotherapy, Louis is introduced to PROMs and the clinic’s patient web portal. He is asked to complete a PROM (EORTC QLQ-C30) at home once a week before each consultation..
Below, you will find different sections of a video example in which Louis’ physician discusses the results of his first PRO assessment with him. Key aspects of PRO-based communication for each phase of the consultation are highlighted.
After greeting Louis, his physician
- asks generally about his overall well-being and uses the response to transition to the PRO assessment
- acknowledges completion of the PRO assessment and explains the value of the results
- mentions domains without reported burden to confirm them and offer encouragement
- mentiones reported burden in some domains without specifying and invites his patient to prioritize the most important issue(s) for further discussion
Nausea: For the symptom Louis prioritised as most important, his physician asks detailed questions about
- how it feels
- possible causes/triggers
- self-management strategies already tried
He listens attentively (eye contact), confirms understanding (repeated nodding, "yes", "okay"), gives appropriate feedback (e.g. on eating most preferred food), and suggests further self-management and clinical interventions.
Fatigue: For the other symptom Louis prioritised as most important, his physician
- introduces the new topic after finishing the previous one
- ensures shared understanding by paraphrasing Louis’ explanation
- empathises the challenge but importance of his suggested self-management intervention (physical activity)
Sleep disturbances/emotional burden: In addition to Louis’ prioritized symptoms, his physician addresses other burdensome symptoms highlighted in the PRO data. He
- normalizes them in the context of Louis’ current disease and treatment stage
- offers encouragement by highlighting the prospect of improvement
- links reported symptoms to each other (sleep disturbance with emotional burden)
- explains why a suggested intervention may benefit not only Louis himself
Louis' physician closes the consultation after
- asking about any additional important issues not covered in the PROMs
- reassuring him of ongoing support
- clarifying that Louis can reach out if further questions or problems arise
- summarising the clinical interventions to be initiated
Van der Willik et al. 2022