Exploring Awareness, Usage, Motivations, and Barriers of Question Prompt Lists Among Asian National Cancer Centers Alliance (ANCCA) Members

O'Brien, Emerald; Nishimata, Nobuo; Obama, Kyoko; Okamura, Masako; Shimazu, Taichi; Kobayashi, Nozomu; Hussain, Qazi Mushtaq; Dorji, Namkha; Tshering, Kinley; Zhang, Yawei; Effendi, Kathryn; Nansalmaa, Erdenekhuu; Tsegmed, Uranchimeg; Luvsannamjil, Enkhee; Yusuf, Aasim; Hwang, William YK; Pitakkarnkul, Supakorn; Ong, Sok King; Shankar, Abhishek; Yusof, Siti Norbayah; Susinadan, Navin Francis; Pradhananga, Kishore Kumar; Biglari, Mohammad; Yim, Sungbin; Chang, Yoon Jung; Vongdala, Champadeng; Cairo, Clarito Jr.; Matsuda, Tomohiro; Inoue, Manami; Nomura, Shuhei; Gatellier, Laureline; Fujimori, Maiko; K. Abe, Sarah

doi:10.31557/APJCP.2026.27.10.3599

Exploring Awareness, Usage, Motivations, and Barriers of Question Prompt Lists Among Asian National Cancer Centers Alliance (ANCCA) Members

Document Type : Research Articles

Authors

¹ The University of Tokyo, Tokyo, Japan.

² St. Luke’s International University, Tokyo, Japan.

³ National Cancer Center, Institute for Cancer Control, Tokyo, Japan.

⁴ Bangladesh Cancer Society, Dhaka, Bangladesh.

⁵ Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.

⁶ National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

⁷ Department of International Trials, Center for Clinical Sciences, Japan Institute for Health Security, Tokyo, Japan.

⁸ Department of Pathology, Keio University School of Medicine, Tokyo, Japan.

⁹ National Cancer Center, Ulaanbaatar, Mongolia.

¹⁰ Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.

¹¹ Department of Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore & Peshawar, Pakistan.

¹² National Cancer Centre, Singapore.

¹³ National Cancer Institute of Thailand, Bangkok, Thailand.

¹⁴ PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam.

¹⁵ Department of Radiation Oncology, All India Institute of Medical Sciences, Delhi, India

¹⁶ National Cancer Institute, Putrajaya, Malaysia.

¹⁷ Community Disease Prevention and Research Center (CDC-Nepal), Lalitpur, Nepal.

¹⁸ Tehran University of Medical Sciences, Tehran, Iran.

¹⁹ National Cancer Center, Goyang, Republic of Korea.

²⁰ Laos Cancer Center, Laos.

²¹ Department of Health-Philippine Cancer Center, Philippines.

²² Global Health Policy Lab, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan.

²³ Global Health Policy Lab, Graduate School of Medicine, Tohoku University, Miyagi, Japan.

²⁴ Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.

²⁵ Economic Research Institute for ASEAN and East Asia, Jakarta, Indonesia.

10.31557/APJCP.2026.27.10.3599

Abstract

Objectives: Effective communication between cancer patients and healthcare providers is essential for patient-centered care and often depends on patients asking questions during consultations. The Question Prompt List (QPL) is a structured communication tool designed to encourage patients to ask questions and support informed decision-making. Most studies on QPL implementation have been conducted in Western countries, where communication practices differ from those in Asia. This study aimed to assess awareness of and willingness to use QPLs among cancer care providers affiliated with the Asian National Cancer Centers Alliance (ANCCA). Study design: Cross-sectional, semi-structured online survey. Methods: An anonymized, self-administered, semi-structured online survey was conducted via Google Forms between July and October 2024. Survey invitations were distributed via email, professional networks, and social media where appropriate. The survey assessed respondents’ demographics, respondents’ prior use of QPLs (Yes/No), prior awareness of the existence of QPLs (Yes/No), preferred communication style (single-response, multiple-choice), and perceived barriers and facilitators to implementation (open-ended response). All questions excluding the two open-ended questions were required for submission. Descriptive statistics were used to analyze quantitative data, and thematic analysis following Braun and Clarke’s framework was used for open-ended responses. Results: Among 85 respondents, 84.7% reported being unaware of QPLs, and 22.4% reported having implemented QPLs in their clinical practice. Among respondents who had not implemented QPLs, 68.2% indicated that they were “Somewhat” or “Very” willing to implement them. Most respondents favored communication styles that emphasize sharing information (16.4%), open and inclusive communication (15.6%), and supportive counseling (15.6%). QPLs are aligned with current attitudes toward patient-provider communication in ANCCA countries. Conclusion: There is substantial opportunity to introduce QPLs across ANCCA countries. This study provides foundational evidence to guide their effective implementation, promoting patient-centered care in Asia.

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