• Becky A Purkaple, Zsolt J Nagykaldi, Arrash Allahyar, Robert Todd, and James W Mold.
• From Family and Preventive Medicine, Springfield Family Medicine, Springfield, OR (BAP); Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK (ZJN); University of Oklahoma College of Medicine, Oklahoma City, OK (AA, RT); George Lynn Cross Emeritus Professor of Family and Preventive Medicine, University of Oklahoma College of Medicine, Oklahoma City, OK (JWM) beckyp@springfieldfam.com.
• J Am Board Fam Med. 2020 Jan 1; 33 (1): 71-79.

PurposePatients are able to participate in quality-of-life (QOL) discussions, but clinicians struggle to incorporate this information into encounters and shared decision making. We designed a study to determine if a clinician-initiated prompt could make patient visits more goal directed.MethodsPatients were given a previsit questionnaire that included QOL questions. Physicians in the control were given no further prompting. The intervention physicians were prompted to ask a QOL question: what things are you unable to do because of your health problems today? A 2-pronged design was used: 1 prepost group where 3 physicians participated in 5 control and 5 intervention encounters (n = 30) and a randomized group in which 11 physicians and their patients were randomly assigned to control or intervention groups (n = 30). Video recordings of the encounters were reviewed to determine if QOL goals were mentioned and if they were utilized in decision making.ResultsFifty-seven (95%) of the 60 patients provided written answers to at least 1 of the QOL questions on the intake form. QOL goals were mentioned during intervention encounters more often than in control groups. QOL information was used in shared decision making in only 4 of the 30 (13%) intervention encounters.ConclusionsPhysicians were able to engage in QOL discussions with their patients, but did not translate that information to medical decision making. More research is needed to understand why clinicians opt not to use QOL information and how to make communication more goal directed.© Copyright 2020 by the American Board of Family Medicine.

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