P0438 - Modifying an Expert-Derived, Achalasia-Specific Question Prompt List (QPL) Communication Tool by Incorporating Patients’ Perspectives and Feedback

Sudharshan Achalu, BA, Rani Berry, MD, Meera Bhargava, MS, George Triadafilopolous, MD, John O. Clarke, MD, Afrin N. Kamal, MD, MS
Stanford University School of Medicine, Redwood City, CA

Introduction: Question prompt lists (QPLs) are structured sets of disease-specific questions intended for patient use, to encourage patients to ask questions and enhance patient-physician communication. Recently, a preliminary 56 question achalasia QPL was created by 19 esophageal experts through a modified Delphi process. Patients’ perspective and feedback on question, however, has not been accounted for in this expert version. We aim to modify an achalasia QPL incorporating patient perspectives and feedback.

Methods: A preliminary achalasia QPL was modified incorporating patient perspective and feedback. Consecutive patients with achalasia followed at Stanford Health Care Esophagus Center between July 2022 and June 2023 were recruited to modify the preliminary expert QPL version. After receiving the QPL in Qualtrics (Provo, UT), patients independently rated questions on a 5-point Likert scale, where 1= “should not be included,” 2= “unimportant,” 3= “don’t know/depends,” 4= “important,” and 5= “essential.” Questions were accepted for inclusion in the QPL with an a priori inter-agreement of ³ 80% ranking (range 4 to 5). At the end, patients were encouraged to propose additional questions to incorporate into the QPL by an open-ended question added to the survey.

Results: Nine patients (Table 1) with a formal diagnosis of achalasia modified the existing QPL. Of the 56 questions experts agreed were important, only 44 questions (78.6%) were accepted for inclusion. Patients disagreed on the importance of questions such as “Can my narcotic medications be giving me an achalasia-like problem?”. In contrast, patients highly agreed on the importance of the question “What lifestyle changes do I need to make?”. Five patients suggested 4 additional questions such as “How does treatment keep my achalasia from progressing?” Incorporating the 4 suggested questions, the final achalasia QPL totaled to 48 questions.

Discussion: With expert input followed by patient feedback, we have developed a patient-centered achalasia QPL aimed to enhance patient-physician communication. Our study highlights the importance of patient perspective and feedback in development of a patient-centric communication tool. Future directions will assess patient and physician usability, as well as rigorously test the efficacy of this QPL on patient outcomes.




Disclosures:


Sudharshan Achalu, BA, Rani Berry, MD, Meera Bhargava, MS, George Triadafilopolous, MD, John O. Clarke, MD, Afrin N. Kamal, MD, MS. P0438 - Modifying an Expert-Derived, Achalasia-Specific Question Prompt List (QPL) Communication Tool by Incorporating Patients’ Perspectives and Feedback, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.