The Patient Concerns Inventory (PCI-HN) is a condition specific prompt list. The concept stems from the literature on the value of question prompt lists in oncology, however as an item the approach has a simplicity which enables its integration into routine care. The PCI-HN was developed as a tool to help overcome some of the difficulties inherent in Health-Related-Quality-of-Life (HRQOL) questionnaires, notably the limited number of issues, the wording, the reliance on Likert scoring as an outcome and the patient questionnaire burden.
The PCI-HN was developed through patient focus groups and first published in 2009 [1]. It is a tool for use in post treatment consultations to help patients raise issue that otherwise, though important, can be missed. It compromises of a list of 56 items and covers physical, treatment, social care, psychological and spiritual aspects. In addition, the PCI-HN lists 18 allied professionals and asks patients to select any that they would like to talk with in clinic or by referral. A systematic review and content comparison of unmet needs self-report measures used in patients with head and neck cancer favoured the PCI compared to 13 other tools [2]. There is also a PCI-HN with specific items appropriate for use at the time of diagnosis of head and neck cancer [3]. The PCI is a free to use resource.
There have been numerous papers on the PCI and these support the premise that:
· It is feasible in routine patient care
· It is appreciated by patients
· It is a tool that helps the ‘hard to reach’ such as elderly and those from low socioeconomic backgrounds.
· It facilitates the ‘conversation’ around potential unmet needs
· Its frequent use provides multiple opportunities for intervention
· It had stratified and make more appropriate the referrals to disciplines (targeted signposting)
· A realisation of the common issues serves as drivers for change reflecting patient experience
· A randomised trial (RCT) provides evidence of benefit as a low-cost intervention which improves patients quality of life
· The PCI approach has been developed in other cancers and long-term conditions such as neuro-oncology, burns, rheumatology, stroke
1.Rogers SN, El-Sheikha J, Lowe D. The development of a PatientsConcerns Inventory (PCI) to help reveal patients concerns in thehead and neck clinic. Oral Oncol 2009. Jul;45(7):555-61. doi:10.1016/j.
2.Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, DhillonHM. Content comparison of unmet needs self-report measures used inpatients with head and neck cancer: A systematic review. Psychooncology2019. Dec;28(12):2295-2306.
3.Byrne MJ, Rogers SN (2017) Service evaluation of patients’ views on the Patients’ Concerns Inventory (at diagnosis). Br J Oral Maxillofac Surg 55(7):714–716.
You can access the PCI-HNC here: Patient Concern Inventory | Liverpool Head & Neck Centre