Agenda-setting in the clinical encounter: A systematic review protocol.

Agenda-setting is a collaborative communication strategy used by a clinician before or at the start of a clinical encounter to work together with the patient to "elicit, propose, and organize" topics to be discussed during the encounter. While clinical visit agenda-setting has been acknowledged as an important element of patient-centered communication, the effectiveness of agenda-setting interventions in improving healthcare outcomes is unclear. To our knowledge, no systematic review has examined clinical visit agenda-setting interventions. The primary aim of the systematic review will be to assess the effects of agenda-setting interventions on outcomes relating to the clinical encounter itself, patients, and clinicians, as well as any other study-specified outcomes. Our secondary aims will be to examine the characteristics and delivery attributes of agenda-setting interventions, as well as how agenda-setting has been operationalized and measured. We will search selected databases (APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, MEDLINE via PubMed, ProQuest, Scopus, and Web of Science) and gray literature from inception until date of search. All studies comparing a clinical visit agenda-setting intervention with either usual care or another agenda-setting intervention will be included. Two independent reviewers will complete article screening and data extraction, with a third independent reviewer resolving any conflicts. We will assess all studies' methodological quality and the quality of their evidence using standardized criteria. If a sufficient number of studies report the same outcomes, we will pool their results and perform a meta-analysis of those outcomes. We will also synthesize all results qualitatively, regardless of whether we are able to complete a meta-analysis. CRD42023468045.

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Copyright: © 2024 Sierpe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

Ailyn Sierpe: No conflicts of interest. Renata Yen: No conflicts of interest. Gabrielle Stevens: I have co-authored a published conference abstract about the feasibility of a goal-based agenda-setting intervention (citation below). This publication may appear in search results for this review, but will not meet eligibility criteria due to the lack of a comparison group. Stevens G, Elwyn G. Feasibility of a goal-based agenda setting intervention for informing conversations in adult cystic fibrosis care: The goal talk study. Journal of Cystic Fibrosis. 2021. https://www.ScienceDirect.com/journal/journal-of-cystic-fibrosis/vol/20/suppl/S2 I have also co-authored a publication about the evaluation of a question prompt intervention to increase shared-decision making in clinical encounters (citation below). This publication may appear in search results for this review, but will likely not meet eligibility criteria due to the study focus. Thompson R, Stevens G, Manski R, Donnelly KZ, Agusti D, Li Z, et al. Right For Me: a pragmatic multi-arm cluster randomised controlled trial of two interventions for increasing shared decision-making about contraceptive methods. medRxiv. 2021. https://www.medrxiv.org/content/10.1101/2021.06.25.21257891v1 Additionally, I have a broad research interest in the development and evaluation of agenda-setting interventions, have received funding for these purposes in the past, and may again in the future. Aricca Van Citters: I have co-authored several publications that include agenda-setting as a component of a larger intervention (citations below), and am conducting research on the types of concerns that agenda-setting questions elicit and their impact on shared decision-making. These publications may appear in search results for this review, but will likely not meet eligibility criteria due to the study focus. Van Citters AD, Gifford AH, Brady C, Dunitz JM, Elmhirst M, Flath J, Laguna TA, Moore B, Prickett ML, Riordan M, Savant AP, Gore W, Jian S, Soper M, Marshall BC, Nelson EC, Sabadosa KA. Formative evaluation of a dashboard to support coproduction of healthcare services in cystic fibrosis. J Cyst Fibros. 2020;19(5):768-76. Epub 2020/05/02. doi: 10.1016/j.jcf.2020.03.009. PubMed PMID: 32354650. Van Citters AD, Holthoff MM, Kennedy AM, Melmed GY, Oberai R, Siegel CA, Weaver A, Nelson EC. Point-of-care dashboards promote coproduction of healthcare services for patients with inflammatory bowel disease. Int J Qual Health Care. 2021;33(Supplement_2):ii40-ii7. doi: 10.1093/intqhc/mzab067. PubMed PMID: 34849970. Van Citters AD, Taxter AJ, Mathew SD, Lawson E, Eseddi J, Del Gaizo V, Ahmad J, Bajaj P, Courtnay S, Davila L, Donaldson B, Kimura Y, Lee T, Mecchella JN, Nelson EC, Pompa S, Tabussi D, Johnson LC. Enhancing Care Partnerships Using a Rheumatology Dashboard: Bringing Together What Matters Most to Both Patients and Clinicians. ACR Open Rheumatol. 2023. Epub 2023/03/01. doi: 10.1002/acr2.11533. PubMed PMID: 36852527. I have also received grant funding to test the feasibility of agenda-setting interventions, as components of larger studies. Glyn Elwyn: I have co-authored a published conference abstract about the feasibility of a goal-based agenda-setting intervention (citation below). This publication may appear in search results for this review, but will not meet eligibility criteria due to the lack of a comparison group. Stevens G, Elwyn G. Feasibility of a goal-based agenda setting intervention for informing conversations in adult cystic fibrosis care: The goal talk study. Journal of Cystic Fibrosis. 2021. https://www.ScienceDirect.com/journal/journal-of-cystic-fibrosis/vol/20/suppl/S2 I have also co-authored a publication about the evaluation of a question prompt intervention to increase shared-decision making in clinical encounters (citation below). This publication may appear in search results for this review, but will likely not meet eligibility criteria due to the study focus. Thompson R, Stevens G, Manski R, Donnelly KZ, Agusti D, Li Z, et al. Right For Me: a pragmatic multi-arm cluster randomised controlled trial of two interventions for increasing shared decision-making about contraceptive methods. medRxiv. 2021. https://www.medrxiv.org/content/10.1101/2021.06.25.21257891v1 I have also co-authored a publication about the development of a clinical visit agenda-setting tool, called Serious Illness Topics (citation below). This publication may appear in search results for this review, but will likely not meet eligibility criteria due to study design. Saunders CH, Durand M-A, Scalia P, Kirkland KB, MacMartin MA, Barnato AE, et al. ‘It helps us say what’s important...’ Developing Serious Illness Topics: A clinical visit agenda-setting tool. Patient Educ Couns 2023;113:107764. https://doi.org/10.1016/j.pec.2023.107764. Additionally, I have a broad research interest in the development and evaluation of agenda-setting interventions, have received funding for these purposes in the past, and may again in the future. Catherine Saunders: I have co-authored a publication about the development of a clinical visit agenda-setting tool, called Serious Illness Topics (citation below). This publication may appear in search results for this review, but will likely not meet eligibility criteria due to study design. Saunders CH, Durand M-A, Scalia P, Kirkland KB, MacMartin MA, Barnato AE, et al. ‘It helps us say what’s important...’ Developing Serious Illness Topics: A clinical visit agenda-setting tool. Patient Educ Couns 2023;113:107764. https://doi.org/10.1016/j.pec.2023.107764. Additionally, I have received funding to observe naturally-occurring clinical visit agenda-setting, although the research has not yet begun and the findings have not yet been published. I have a research interest in clinical visit agenda-setting and will likely publish on this topic in the future.