Developing a framework for clinical conversations using a qualitative analysis of the patient experience of SIMPLIFY.

Objectives: We explored the impact of taking part in a medication discontinuation study for people with cystic fibrosis (CF) on subsequent clinical conversations and what interviewees valued as characteristics of these conversations.

Methods: This analysis is part of the Qualitative Understanding of the Experience of SIMPLIFY Trial (QUEST), a qualitative companion study to a discontinuation trial of two commonly prescribed medications for people with CF. We interviewed 109 total individuals (87 people with CF and 22 caregivers). The interviews were analyzed to explore the influence of participation in a discontinuation study on clinical conversations.

Results: Respect emerged as an overarching theme of these interviews: how much the interviewees respected their clinicians and how they appreciated having their autonomy respected too. Other desirable attributes of clinical conversations surfaced including the importance of reciprocity, empowerment, sensitivity, partnership, empathy, consideration and transparency; (R.E.S.P.E.C.T).

Conclusions: Communication is a fundamental aspect of chronic disease management. This population study focused on patient perspectives of clinical conversations after sharing the experience of being in a novel discontinuation study. Since the acronym R.E.S.P.E.C.T. emerged from the data, we believe it has value as a framework for clinical conversations with people who have chronic conditions that require active selfmanagement.