Editor—We were interested in Slowie's suggestions on helping patients to communicate better with them1 as we recently carried out a randomised controlled trial to test a written prompt to aid doctor-patient communication in an outpatient setting.2 We sent a letter and help card to a random sample of patients at home before their appointment to encourage them to prepare and prioritise questions to ask the doctor at the consultation. The letter (explaining that questions would be expected but were not obligatory) was designed to give patients permission to ask questions.
The help card was pocket sized and included suggested generic questions (for example, about diagnosis, cause, prognosis, tests, treatment alternatives) and also had space for patients to list their own questions. After their consultation patients were sent a postal questionnaire to complete at home. Analysis of the questionnaires provided quantitative and qualitative data about patients' information requirements and whether they were fulfilled.
Half the patients who were sent a help card said that they had got more out of their consultation as a result, yet few significant differences were found between the group sent a help card and the control group. Our results highlight the difficulties that outpatients have in asking questions and discussing topics fully at their initial consultation, even when they have thought of questions in advance. Some of the patients still did not feel able to refer to their cards during the consultation, perhaps because of a fear of being labelled difficult.3
A written prompt may help new patients to focus on their appointment and think of questions beforehand, and this may help them to get more out of their consultation. Patients also, however, need help and encouragement from staff during the consultation if communication is to be successful.
References
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