Does a List of Potential Questions Increase Patient Comfort with Decisions in Musculoskeletal Specialty Care?

Objectives Important decisions about tests and treatment might benefit from prompting people to be ready to ask questions, particularly in musculoskeletal specialty care, where many tests and treatments are discretionary. Methods We enrolled 146 adult patients in a prospective, 1:1 randomized controlled trial, with about half receiving a list of questions people with musculoskeletal symptoms might ask a specialist before the visit. After the visit, patients in both groups completed a survey that included demographics, measures of comfort with decisions, agency, perceived clinician empathy (using two different measures), and an 11-point ordinal measure of satisfaction with the visit. Results There were no significant differences between the two groups regarding whether or not they received a list of questions prior to the visit. Conclusion The observation that a question list did not improve patient agency or experience suggests—in combination with other lines of evidence–that preparing patients for greater agency may not be as effective as training clinicians in a more guiding rather than directing communication style. Whether a question prompt list improves patient agency and experience or limits decision conflict beyond what patients experience without it.