ACCRUE: Advancing consultation recall and understanding

Communication between doctors and their patients can often be poor especially when it comes to life-threatening conditions. Many patients find it difficult to remember information and discuss certain topics during (e.g prognosis) a medical consultation.

Several communication interventions have been developed to try to improve doctor-patient communication. Two examples of such interventions are audio–recordings (AR) and question prompt lists (QPL). Despite evidence supporting routine use in clinical service delivery, to our knowledge neither QPLs nor audio-recordings of consultations are part of usual care in Australia.

The aim of this study was to explore barriers and facilitators to implementing QPLs and AR as a component of usual care in order to inform a future implementation study.


This study provides many useful contextual insights into the critical issues around implementing QPLs and AR strategies into routine healthcare. While there was consensus that these strategies can be of benefit to patients, it was clear that when thinking about applying AR and QPLs into standard practice there were many important issues to be agreed or resolved ahead of implementation.

With particular regard to reducing medico-legal risk through AR of clinical consultations few benefits were identified for the health system as a whole. Ambiguity about medico-legal issues will continue to be a persistent barrier to implementation of AR. Medico-legal risk concerns will need to be fully explored before AR can be routinely implemented.


Peter MacCallum Cancer Centre


Victorian Comprehensive Cancer Centre

Principal Investigator/s

Mei Krishnasamy

Contact details

Prof Mei Krishnasamy

Chair in Cancer Nursing I Department of Nursing

University of Melbourne Centre for Cancer Research

VCCC Research and Education Lead - Cancer Nursing

Email: [email protected]


We extend our thanks to Ms Lahiru Russell for research assistance work on ACCRUE.

Publications & presentations

The ACCRUE study has now been published. The full publication is accessible via open access.