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Improving Communication of Health-Related Quality of LifeImproving Communication of Health-Related Quality of Life

JAMA. 2003;289(13):1636-1637. doi:10.1001/jama.289.13.1636-a
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AUTHOR INFORMATION

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

IMPROVING COMMUNICATION OF HEALTH-RELATED QUALITY OF LIFE

To the Editor: Dr Detmar and colleagues1 found that a questionnaire that assessed health-related quality of life (HRQL) improved the quality of patient-physician communication about patients' HRQL, and also led to greater satisfaction among both patients and physicians.

These results are not surprising. Since the questionnaire is known to have adequate construct validity,2 one would expect it to detect meaningful and clinically relevant issues relating to HRQL. Thus, the study simply showed that physicians in this sample had not been adequately assessing HRQL problems in the course of their standard practice.

For physicians who are not already paying adequate attention to HRQL issues, the crucial question is how to motivate them to use HRQL questionnaires in practice. Any implementation strategy must address local barriers to change, which may relate to physicians, patients, or the environment.3 One promising approach is computer-based administration, scoring, and presentation of HRQL results.4

References
Detmar SB, Muller MJ, Schornagel JH, Wever LDV, Aaronson NK. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial.  JAMA.2002;288:3027-3034.
Aaronson NK, Ahmedzai S, Bergman B.  et al.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.  J Natl Cancer Inst.1993;85:365-376.
Cabana MD, Rand CS, Powe NR.  et al.  Why don't physicians follow clinical practice guidelines? a framework for improvement.  JAMA.1999;282:1458-1465.
Velikova G, Brown JM, Smith AB, Selby PJ. Computer-based quality of life questionnaires may contribute to doctor-patient interactions in oncology.  Br J Cancer.2002;86:51-59.

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Detmar SB, Muller MJ, Schornagel JH, Wever LDV, Aaronson NK. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial.  JAMA.2002;288:3027-3034.
Aaronson NK, Ahmedzai S, Bergman B.  et al.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.  J Natl Cancer Inst.1993;85:365-376.
Cabana MD, Rand CS, Powe NR.  et al.  Why don't physicians follow clinical practice guidelines? a framework for improvement.  JAMA.1999;282:1458-1465.
Velikova G, Brown JM, Smith AB, Selby PJ. Computer-based quality of life questionnaires may contribute to doctor-patient interactions in oncology.  Br J Cancer.2002;86:51-59.
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