Prompting Better Care: Improving Conversations With Question Prompt Lists

A question prompt list (QPL) is a set of questions, topics, prompts, scenarios, or concerns. In the health care setting, pharmacists apply this tool to help patients ask questions that may address their worries or challenges. With proper use, QPLs improve patients’ ability to ask questions, encourage critical thinking, and better prepare them to make treatment decisions.

QPL use in the pharmacy setting may enhance patient engagement while allowing pharmacists to showcase their medication-related expertise. The journal Research in Social and Administrative Pharmacy has published study findings that demonstrate the feasibility and impact of QPLs in pharmacy encounters and patient activation.

The QPL for this study included 3 sections: medications, best use, and follow-up. Each section prompted questions about use, interactions, and adverse effects. The table lists some examples of the questions included.

Table. Example QPL

First, researchers contacted community pharmacy chains in Sweden. Before data collection, participating pharmacists received QPL training, and methods for data collection included audio recordings. During encounters, pharmacists introduced the QPL. While the patient reviewed the QPL, the pharmacist checked and verified the patient’s medication(s). Finally, pharmacists returned to the patient with their medication(s) and resumed the conversation.

Researchers included 50 pharmacy encounters from 15 pharmacists. Interactions lasted approximately 5.2 minutes, and 65.3% of participating patients were female. The most frequent age group included 66- to 80-year-olds taking 3 to 4 medications.

A question prompt list is a set of questions or prompts | Image credit: © BillionPhotos.com | stock.adobe.com

The initial phase of the visit established rapport for current and subsequent interactions, but researchers noted that pharmacists struggled to resume conversations after interruptions between initial interactions and medication pickup. This scenario is like receiving another call during a phone conversation, interrupting it by hanging up, and needing to call back to continue.

Regardless of how the pharmacist introduced the QPL, half of the patients responded positively and used the list. Receptive patients applied the tool to gather information and discuss personal issues. Those who chose not to participate provided explanations for their decision. For patients who utilized the tool, pharmacists often adequately answered the questions using a checklist approach to counseling.

To further increase patient activation, the authors suggested adding lifestyle-based questions to the QPL. The study also discussed converting the QPL to an electronic format to facilitate long-term follow-up between pharmacists and patients.

Because researchers designed the study to determine the feasibility of implementing QPLs, the actual impact of this tool on patient activation remains unclear. The authors concluded that a QPL may establish a conversational space within this setting. This is significant considering the short interactions that typically occur within community pharmacy.

REFERENCE

Svensberg K, Kaae S, Mottelson NB, Persson CL. Identifying critical elements in using question prompt lists at the pharmacy counter to induce patient activation–using principles of conversation analysis. Res Social Adm Pharm. 2025;21(2):74-84. doi:10.1016/j.sapharm.2024.10.008