Abstract
OBJECTIVE: This study aimed to evaluate the effectiveness of question prompt list (QPL) interventions in patients with cancer and to synthesize the delivery characteristics of such interventions. METHODS: A systematic search of five electronic databases was conducted for English-language randomized controlled trials published up to January 2025. Two independent reviewers performed study selection and data extraction. Eligible studies included cancer patients aged 16 years or older, with QPLs used in the intervention group to facilitate patient-physician communication. The Cochrane Risk of Bias 2.0 tool was used to assess study quality, and meta-analysis was conducted using RevMan 5.4 software. RESULTS: A total of 302 records were identified, of which 14 studies (reported in 16 articles) met the inclusion criteria. Interventions were categorized into two groups: QPLs with instructions and QPLs without instructions. Pooled meta-analysis demonstrated that QPL interventions significantly enhanced patient engagement in shared decision-making, increased the number of questions asked, and improved the perceived helpfulness of the material. Compared to QPL alone, QPL with instructions further increased the number of patient-initiated questions and improved decision self-efficacy. CONCLUSIONS: QPL interventions with accompanying instructions showed superior effectiveness in promoting patient question-asking behavior and enhancing decision self-efficacy. This review underscores the potential of QPLs-particularly those with instructions-to improve patient-physician communication. Further research is warranted to refine these interventions and explore their role in reducing patient anxiety. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42024594145.