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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 5/2020

Open Access 01-05-2020 | Care | Palliative and Supportive Care (MP Davis, Section Editor)

The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review

Authors: Naomi C. A. van der Velden, MSc, Maartje C. Meijers, MSc, Paul K. J. Han, MD, PhD, Hanneke W. M. van Laarhoven, MD, PhD, Ellen M. A. Smets, PhD, Inge Henselmans, PhD

Published in: Current Treatment Options in Oncology | Issue 5/2020

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Abstract

Background

While prognostic information is considered important for treatment decision-making, physicians struggle to communicate prognosis to advanced cancer patients. This systematic review aimed to offer up-to-date, evidence-based guidance on prognostic communication in palliative oncology.

Methods

PubMed and PsycInfo were searched until September 2019 for literature on the association between prognostic disclosure (strategies) and patient outcomes in palliative cancer care, and its moderators. Methodological quality was reported.

Results

Eighteen studies were included. Concerning prognostic disclosure, results revealed a positive association with patients’ prognostic awareness. Findings showed no or positive associations between prognostic disclosure and the physician-patient relationship or the discussion of care preferences. Evidence for an association with the documentation of care preferences or physical outcomes was lacking. Findings on the emotional consequences of prognostic disclosure were multifaceted. Concerning disclosure strategies, affective communication seemingly reduced patients' physiological arousal and improved perceived physician’s support. Affective and explicit communication showed no or beneficial effects on patients’ psychological well-being and satisfaction. Communicating multiple survival scenarios improved prognostic understanding. Physicians displaying expertise, positivity and collaboration fostered hope. Evidence on demographic, clinical and personality factors moderating the effect of prognostic communication was weak.

Conclusion

If preferred by patients, physicians could disclose prognosis using sensible strategies. The combination of explicit and affective communication, multiple survival scenarios and expert, positive, collaborative behaviour likely benefits most patients. Still, more evidence is needed, and tailoring communication to individual patients is warranted.

Implications

Future research should examine the effect of prognostic communication on psychological well-being over time and treatment decision-making, and focus on individualising care.
Appendix
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Metadata
Title
The Effect of Prognostic Communication on Patient Outcomes in Palliative Cancer Care: a Systematic Review
Authors
Naomi C. A. van der Velden, MSc
Maartje C. Meijers, MSc
Paul K. J. Han, MD, PhD
Hanneke W. M. van Laarhoven, MD, PhD
Ellen M. A. Smets, PhD
Inge Henselmans, PhD
Publication date
01-05-2020
Publisher
Springer US
Keyword
Care
Published in
Current Treatment Options in Oncology / Issue 5/2020
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-020-00742-y

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