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The use of audiotapes in consultations with women from high risk breast cancer families: a randomised trial
  1. E Lobb1,
  2. P Butow1,2,
  3. B Meiser2,
  4. A Barratt3,
  5. J Kirk4,
  6. M Gattas5,
  7. E Haan6,
  8. K Tucker7
  1. 1Medical Psychology Research Unit, Department of Psychological Medicine, University of Sydney, Sydney, NSW 2006, Australia
  2. 2Department of Psychological Medicine, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
  3. 3Department of Public Health and Community Medicine, University of Sydney, Sydney, NSW 2006, Australia
  4. 4Familial Cancer Service, Westmead Hospital, Westmead, NSW 2145, Australia
  5. 5Queensland Clinical Genetics Service, Royal Children's Hospital, Herston, Queensland 4006, Australia
  6. 6South Australian Clinical Genetics Service, Women's and Children's Hospital, Adelaide, 5000 South Australia
  7. 7Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW 2031, Australia
  1. Correspondence to:
 Dr E Lobb, Medical Psychology Research Unit, Department of Psychological Medicine, University of Sydney, Sydney, NSW 2006, Australia;
 lizlobb{at}med.usyd.edu.au

https://doi.org/10.1136/jmg.39.9.697

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    Recall of medical information is notoriously poor. In methodologically rigorous studies of cancer patients' recall, our group found that patients recall about 25% of all the facts presented and just under half of the five to six facts nominated as particularly crucial by the doctor.1 Studies on genetic counselling, on the other hand, generally show that genetic counselling appears to be effective in increasing knowledge of the mode of inheritance.2 However, risk figures are generally poorly recalled, suggesting that there may be potential for improving the effectiveness of information giving.3

    Several sources of poor patient understanding have been identified, including poor communication techniques and lack of time in the consultation,4 patient anxiety,4,5 and patient denial.6 Thus, interventions designed to improve patient understanding need to compensate for anxiety and time constraints by providing a mechanism for flexible information review, to be sensitive to patients' varying information needs, and to be economical in time and costs. An audiotape of the consultation appears to satisfy these criteria.

    A recent review of published reports on audiotaping in the oncology consultation concluded that providing audiotapes to patients is beneficial.7 It can allow for review of the information presented, serve as a stimulus for future discussion, facilitate family communication about the illness, and can be a clinically effective intervention as it is inexpensive and easily incorporated into clinical practice.

    Studies have examined the effect of audiotapes on patients' psychological well being, information recall, and satisfaction. Results for psychological well being have been conflicting. Studies have ranged from showing a significant reduction in anxiety,8 to no reduction,1 to showing a detrimental effect.9 Differences in findings may be partly explained by the heterogeneity of samples studied. For example, studies included patients with advanced carcinomas,8 both newly …

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