Development of a Patient Question Prompt List for Older Adults with Early-Stage Hormone Receptor-Positive Breast Cancer.

Older women with early-stage hormone receptor-positive (HR+)/human epidermal growth factor receptor-2-positive (HER2-) breast cancer face many preference-based decisions regarding the treatment they receive, as some therapies can be safely omitted. Our objective was to develop a question-prompt list for patients >70 with early-stage HR+/HER2- breast cancer for use at their initial surgical consultation. We recruited women diagnosed at age ≥ 70 with cT1-2N0 HR+/HER2- breast cancer in the past year to participate in virtual focus group about their experience gathering information about their diagnosis and treatment, and to gather feedback on a question-prompt list. Baseline questionnaires were gathered and focus groups were then recorded and transcribed. A codebook was developed based on a combination of deductive and inductive codes. The research team conducted a thematic analysis and made iterative revisions to the list. Four focus groups were conducted with 4-5 participants in each (n=19 participants). The average age of participants was 74.1 (SD 3.2); 18 were non-Hispanic White. Major themes included: 1) patients and physicians share responsibility for meeting patients’ informational needs, 2) a question-prompt list is one of many helpful strategies for cancer information gathering, and 3) question-prompt lists must account for different needs by phase in the cancer journey. We developed a question-prompt list that was found useful to women ≥70 with HR+/HER-2- early-stage breast cancer. Next, we will test the effects of this list on patient-engagement and the quality of patient-physician conversations at initial breast surgical oncology consultations in a pilot trial.