1. Development of the Patient Concerns Inventory
Why
What
How
When 8

2. Patient and carers living the aftermath of cancer
Development of the Patient Concerns Inventory
Major treatments for H&N cancer
Major impact on patients and carers of H&N cancer
Patient and carers living the aftermath of cancer
Many unmet needs at different times
Patients and Carers fail to express their concerns
Clinicians fail to pick up patients concerns
How are concerns identified by CNS using communication skills 8

3. Identifying concerns has positive benefit
Better communication
Improved satisfaction
Better coping
Quicker adaptation
Improved HRQOL
Reduced health costs
There are evidence based interventions

4. HRQOL questionnaires are limited by their structure and interpretation
Patients experience a range of problems of different intensities, at different times
HRQOL questionnaires are limited by their structure and interpretation
BUT HRQOL questionnaires can help identify patients doing badly 8

5. HRQOL questionnaires are limited by their structure and interpretation
Patients experience a range of problems of different intensities, at different times
HRQOL questionnaires are limited by their structure and interpretation
BUT HRQOL questionnaires can help identify patients doing badly 8

6. Screening in clinic
Rogers SN, Lowe D Screening for dysfunction to promote MDT intervention using the University of Washington Quality of Life questionnaire (UW-QOL) Archives of Otolaryngology Head & Neck Surg. 2009; 135: 8

7. Touchscreen

8. Better, stable, worse Screening in clinic UW-QOL v4 Domain scores
Importance
Freetext

9. Screening in clinic

10. Outline
Patient Concerns Inventory
Why
What
How
When 8

11. National Associations
Patient Concerns Inventory
Item generation
HRQOL
National Associations
Patients
Carers
Head and Neck team
Evolving list

12. Patient Concerns Inventory : Issues they wish to discuss
Rogers SN, El-Sheikha J, Lowe D. The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic. Oral Oncol. 2009; 45: 8

13. Patient Concerns Inventory8

14. Patients Concerns Inventory Patient Concerns Inventory8

15. PCI: results
The overall median time for completing the TST was 8 minutes (IQR 6 to 11), range 3 to 27)
The length of the consultation with TST - median (IQR) 8 (5 to 10) minutes
The length of the consultation without TST - median (IQR) 7 (4 to 14) minutes 8

16. PCI: results
62% patients felt it made a very much /quite a bit difference to their consultation
Patient comments:
-’it made it a bit more personal’
- ‘reminds me of the points I want discuss’
- ‘allows consultation to get straight to the point’
-’ encourages me to talk about things I would otherwise not discuss’
-’if it helps you its fine by me’ 8

17. Patient Concerns Inventory : Issues they wish to discuss
The median number of issues: 3
IQR 1-6
range 0 to 21
82% selecting at least 1 issue 8

18. Screening in clinic

19. Patient Concerns Inventory8

20. Outline
Patient Concerns Inventory
Why
What
How
When 8

21. Patient Concerns Inventory8

22. Outline
Patient Concerns Inventory
Paper vs Touchscreen
Internet 8

23. No issues Two specific issues Scary issues Multiple issues
PCI: Five groups of patients
No issues
Two specific issues
Scary issues
Multiple issues
Issues not mentioned 8

24. Outline
Patient Concerns Inventory
Why
What
How
When 8

25. Barriers to its introduction
Routine
Targeted groups
Targeted times
Patient Concerns Inventory 8

26. Questions and comments
Theoretical framework ?
Consultation - communication
Health economics
Concern severity
Holistic assessment
Patient experience
Intervention
Training
A lot still to find out about how best to use this tool

27. Patient Concerns Inventory www.headandneckcancer.co.uk8