Anna L. Parks, Ayush Thacker, Daniel Dohan, Liliana A. Ramirez Gomez, Seth A. Gale, Kim G. Johnson, Christine S. Ritchie, Sachin J. Shah, Joanna Paladino
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Hybrid inductive-deductive thematic analysis by interdisciplinary researchers.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>In 27 clinician interviews (women [<i>n</i> = 17], White individuals [<i>n</i> = 19], neurologists [<i>n</i> = 17]), three themes emerged. First, clinicians varied in techniques used and concepts emphasized, including using analogies, discussing statistics, and emphasizing versus de-emphasizing risks. Second, patient contextual factors (e.g., comorbidities), hopes, and fears shaped communication. Third, clinician communication varied by training, personal style, and ambivalence. While clinicians honor patients’ choices to pursue treatment, many do not “recommend” it (but may recommend against it).</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>Preliminary insights about how clinicians communicate tradeoffs can guide future shared decision-making interventions for mAbs.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>This qualitative study among 27 clinicians across seven academic medical centers examined how clinicians communicate with people with Alzheimer's disease about risks and benefits of anti-amyloid therapy, which can influence treatment decisions.</li>\n \n <li>Clinicians varied in what techniques they employed and how they portrayed risks and benefits, and whether they incorporated patients’ values.</li>\n \n <li>They cited comorbidities, eligibility criteria fit, and degree of social support or family involvement in decisions as factors used in framing discussions, while fewer used patients’ goals to guide discussion.</li>\n \n <li>The professional training, individual practice style, and personal sense of ambivalence of clinicians shaped conversations.</li>\n \n <li>These findings can guide future interventions to improve communication and shared decision-making.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":53225,"journal":{"name":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","volume":"11 3","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.70150","citationCount":"0","resultStr":"{\"title\":\"Characterizing clinician communication with patients about lecanemab: A qualitative study of clinicians across seven academic medical centers\",\"authors\":\"Anna L. 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Hybrid inductive-deductive thematic analysis by interdisciplinary researchers.</p>\\n </section>\\n \\n <section>\\n \\n <h3> RESULTS</h3>\\n \\n <p>In 27 clinician interviews (women [<i>n</i> = 17], White individuals [<i>n</i> = 19], neurologists [<i>n</i> = 17]), three themes emerged. First, clinicians varied in techniques used and concepts emphasized, including using analogies, discussing statistics, and emphasizing versus de-emphasizing risks. Second, patient contextual factors (e.g., comorbidities), hopes, and fears shaped communication. Third, clinician communication varied by training, personal style, and ambivalence. 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Characterizing clinician communication with patients about lecanemab: A qualitative study of clinicians across seven academic medical centers
INTRODUCTION
Anti-amyloid monoclonal antibodies (mAbs) slow cognitive decline in Alzheimer's disease but may cause amyloid-related imaging abnormalities (ARIA), which can rarely be disabling or fatal. This qualitative study investigates how clinicians communicate the benefits and risks of mAbs to patients and caregivers.
METHODS
Semi-structured interviews with clinicians who prescribe mAbs at seven academic medical centers. Hybrid inductive-deductive thematic analysis by interdisciplinary researchers.
RESULTS
In 27 clinician interviews (women [n = 17], White individuals [n = 19], neurologists [n = 17]), three themes emerged. First, clinicians varied in techniques used and concepts emphasized, including using analogies, discussing statistics, and emphasizing versus de-emphasizing risks. Second, patient contextual factors (e.g., comorbidities), hopes, and fears shaped communication. Third, clinician communication varied by training, personal style, and ambivalence. While clinicians honor patients’ choices to pursue treatment, many do not “recommend” it (but may recommend against it).
DISCUSSION
Preliminary insights about how clinicians communicate tradeoffs can guide future shared decision-making interventions for mAbs.
Highlights
This qualitative study among 27 clinicians across seven academic medical centers examined how clinicians communicate with people with Alzheimer's disease about risks and benefits of anti-amyloid therapy, which can influence treatment decisions.
Clinicians varied in what techniques they employed and how they portrayed risks and benefits, and whether they incorporated patients’ values.
They cited comorbidities, eligibility criteria fit, and degree of social support or family involvement in decisions as factors used in framing discussions, while fewer used patients’ goals to guide discussion.
The professional training, individual practice style, and personal sense of ambivalence of clinicians shaped conversations.
These findings can guide future interventions to improve communication and shared decision-making.
期刊介绍：
Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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