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ASCO Guidelines to Improve Clinician Communication with Patients

Clear and effective communication is a core element of patient-centered oncology care.
Oncology is a challenging field with high stakes and vulnerable patients. The treatment regimens used are often highly complex and may be toxic even at therapeutic doses. Oncology care is a multidisciplinary speciality.

Because of these challenges oncologists require specialized communication skills.
A 2017 guideline from the American Society of Clinical Oncology (ASCO) outlines best practices for cancer clinicians when communicating with patients and their loved ones. The guidelines emphasize the importance of relationships that more effectively support patients.

“Clinicians face a monumentally difficult task: to guide patients on what may be the scariest and most unpleasant journey of their lives. We need to preserve their hope while at the same time giving them accurate information,” said Timothy Gilligan, MD, FASCO, co-chair of the ASCO Expert Panel that developed the guideline. “Helping oncology clinicians improve their communication skills ultimately helps patients, and that is what is most important.”

The ASCO panel included experts from medical oncology, psychiatry, nursing, hospice and palliative medicine as well as communication skills experts. Also included were experts in health disparities and advocacy. The panel conducted a systematic review of medical literature published between January 2006 to October 2016.

The Key Guideline Recommendations:

  • Training programs in communication skills should be available to oncologists at every level of practice.
  • Care goals should be established early by oncologists with their patients. These care goals should align with patient values and priorities.
  • Clinicians should encourage patients to discuss concerns and take an active role in their care.
  • Conversations about patients’ end-of-life preferences should start early in patients with an incurable illness. This topic should be raised periodically, based on symptoms, disease progression, and patient preferences.
  • Patient concerns about cost of care should be part of any consultation. Referral of the patient and their family to a financial counsellor or social worker is often indicated.
  • All treatment options should be brought to the attention of the patient. This includes clinical trials or palliative care alone for certain patients.

“The guideline is both patient-centered and relationship-centered. It underscores that an important skill for each provider is to understand the patient as an individual and their families’ unique needs,” said Walter F. Baile, MD, co-chair of the ASCO Expert Panel that developed the guideline. “The recommendations can help doctors form a trusting relationship with patients that is characterized by empathy, honesty, and a human connection with the patient and family.”
Reference:Gilligan T, Coyle N, Frankel RM, Berry DL, et al. Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline. Journal of Clinical Oncology 35, no. 31 (November 1 2017) 3618-3632.

Link: http://ascopubs.org/doi/full/10.1200/JCO.2017.75.2311

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