AIM: Computer intervention can help oncologists react to patients

A brief computerized intervention improves how oncologists respond to patients' expressions of negative emotions, according to an article published in the Nov. 1 edition of the Annals of Internal Medicine.

James A. Tulsky, MD, from Duke University in Durham, N.C., and colleagues sought to test whether a brief, computerized intervention improves oncologists' responses to patient expressions of negative emotion.

“Quality cancer care requires addressing patients' emotions, which oncologists infrequently do,” the authors wrote, adding that multi-day courses can teach oncologists skills to handle emotion; however, such workshops are long and costly.

A randomized, controlled, parallel-group trial stratified by site, sex and oncologic specialty at oncology clinics at a comprehensive cancer center and Veterans Affairs Medical Center in Durham, N.C., and a comprehensive cancer center in Pittsburgh was designed where oncologists were randomly assigned to receive a communication lecture or the lecture plus a tailored CD-ROM.

The number of participants included 48 medical, gynecologic and radiation oncologists and 264 patients with advanced cancer. Oncologists were randomly assigned in a 1:1 ratio to receive an interactive CD-ROM about responding to patients' negative emotions. The CD-ROM included tailored feedback on the oncologists' own recorded conversations.

Oncologists in the intervention group used more empathic statements (relative risk, 1.9; p = 0.024) and were more likely to respond to negative emotions empathically (odds ratio, 2.1; p = 0.028) than control oncologists, the authors found. Patients of intervention oncologists reported greater trust in their oncologists than did patients of control oncologists (estimated mean difference, 0.1; p = 0.036).

There was no significant difference in perceptions of communication skills, Tulsky and company stated.

The authors noted limitations of their study, as they stated the findings may not be generalizable outside of academic medical centers nor were long-term effects examined.

“This…trial demonstrates that a brief, disseminable technology can improve oncologists’ empathic behavior,” the authors concluded. “This, in turn, improves patient trust, which may lead to better adherence to therapy and quality of life.”

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