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Am Fam Physician. 2024;109(5):478

Clinical Question

Does delivery of bad news via telephone increase psychological stress more than in-person communication?

Bottom Line

Delivering bad news by telephone does not affect levels of anxiety, depression, or satisfaction with care vs. delivering the news in person. (Level of Evidence = 2a)


The researchers searched four databases and reference lists of screened articles to identify 11 observational and randomized controlled trials that investigated differences in psychological distress of breaking bad news by telephone compared with delivering the news in person to patients or next of kin. Two authors independently selected articles for inclusion and abstracted the relevant data. Most of the studies (seven) evaluated disclosure of malignancy diagnoses; the remaining studies included results of genetic testing, Alzheimer disease, and hypertrophic cardiomyopathy. Overall, the study quality was moderate to good. There was no difference in psychological distress when bad news was delivered via telephone in terms of anxiety (three studies, 285 participants), depression (three studies, 284 participants), and posttraumatic stress disorder (two studies, 171 participants). Results were similar for satisfaction with care. In a single study, there was no association between level of trust, which was high, and disclosure of bad news via telephone vs. in person.

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POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see Copyright Wiley-Blackwell. Used with permission.

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