OBJECTIVE: Agreement between patients and physicians is an indicator of successful communication. Concordance in domains of communication among patients with heart disease and communication barriers has not been studied. METHODS: English, Spanish, or Cantonese-speaking patients seen at a public hospital cardiology clinic were assessed with pre-visit questionnaires. Surveys of patients and their physicians immediately after the visit asked each about: (1) cardiac functional status, (2) barriers to self-management, (3) cardiac diagnoses, and (4) treatment. We assessed patient-physician concordance in these domains. RESULTS: 179 patients and 56 physicians completed the study. Patients had low educational attainment, limited literacy and limited English proficiency. Physicians underestimated patients' cardiac functioning status (NYHA Classes 2-4), by 1 class or more in 50% of visits. Physicians were frequently unaware of medication (38/57, 67%) and psychosocial (61/88, 69%) barriers. Patients were unable to describe even 1 matching diagnosis (72/170, 42% concordant) among 5 categories. Physicians' reported medication changes in 106/179 (59%) but patients failed to report these changes in 55% (58/106). Multivariate logistic regression analyses showed no significant association between patient characteristics and concordance. CONCLUSION: Patients and physicians often fail to communicate effectively and determinants of concordance in CVD care require further investigation. PRACTICE IMPLICATIONS: Developing strategies to improve communication within the medical encounter are critical to improving ambulatory chronic disease management.
OBJECTIVE: Agreement between patients and physicians is an indicator of successful communication. Concordance in domains of communication among patients with heart disease and communication barriers has not been studied. METHODS: English, Spanish, or Cantonese-speaking patients seen at a public hospital cardiology clinic were assessed with pre-visit questionnaires. Surveys of patients and their physicians immediately after the visit asked each about: (1) cardiac functional status, (2) barriers to self-management, (3) cardiac diagnoses, and (4) treatment. We assessed patient-physician concordance in these domains. RESULTS: 179 patients and 56 physicians completed the study. Patients had low educational attainment, limited literacy and limited English proficiency. Physicians underestimated patients' cardiac functioning status (NYHA Classes 2-4), by 1 class or more in 50% of visits. Physicians were frequently unaware of medication (38/57, 67%) and psychosocial (61/88, 69%) barriers. Patients were unable to describe even 1 matching diagnosis (72/170, 42% concordant) among 5 categories. Physicians' reported medication changes in 106/179 (59%) but patients failed to report these changes in 55% (58/106). Multivariate logistic regression analyses showed no significant association between patient characteristics and concordance. CONCLUSION:Patients and physicians often fail to communicate effectively and determinants of concordance in CVD care require further investigation. PRACTICE IMPLICATIONS: Developing strategies to improve communication within the medical encounter are critical to improving ambulatory chronic disease management.
Authors: Daniel S Budnitz; Daniel A Pollock; Kelly N Weidenbach; Aaron B Mendelsohn; Thomas J Schroeder; Joseph L Annest Journal: JAMA Date: 2006-10-18 Impact factor: 56.272
Authors: Dean Schillinger; John Piette; Kevin Grumbach; Frances Wang; Clifford Wilson; Carolyn Daher; Krishelle Leong-Grotz; Cesar Castro; Andrew B Bindman Journal: Arch Intern Med Date: 2003-01-13
Authors: Leah S Karliner; Andrew Auerbach; Anna Nápoles; Dean Schillinger; Dana Nickleach; Eliseo J Pérez-Stable Journal: Med Care Date: 2012-04 Impact factor: 2.983
Authors: Leigh F Callahan; Victoria Hawk; Rima Rudd; Betsy Hackney; Sonia Bhandari; Lindsay P Prizer; Thomas K Bauer; Beth Jonas; Philip Mendys; Darren DeWalt Journal: Res Social Adm Pharm Date: 2013-07-16
Authors: Jane R Schubart; Lisa Toran; Megan Whitehead; Benjamin H Levi; Michael J Green Journal: Support Care Cancer Date: 2012-11-23 Impact factor: 3.603
Authors: Karen A Amirehsani; Jie Hu; Debra C Wallace; Zulema A Silva; Sarah Dick; Lauren N West-Livingston; Christina R Hussami Journal: J Community Health Nurs Date: 2017 Jul-Sep Impact factor: 0.974
Authors: Yoon-Sook Kim; Hyun Ah Kim; Moon-Sook Kim; Hyuo Sun Kim; Mi Jeong Kwak; Jahae Chun; Jee-In Hwang; Hyeran Kim Journal: Int J Environ Res Public Health Date: 2020-10-07 Impact factor: 3.390
Authors: Dean Schillinger; Nicholas D Duran; Danielle S McNamara; Scott A Crossley; Renu Balyan; Andrew J Karter Journal: Sci Adv Date: 2021-12-17 Impact factor: 14.136