Advertisement

From the Editors’ Desk: Why Does Not Improvement in Communication Lead to Improvement in “Hard” Outcomes?

  • Jeffrey L. JacksonEmail author
Editorial

The quality of communication is important in provider-patient interactions. Studies have consistently shown that encounters that are more interactive result in patients with higher levels of satisfaction and trust.1 What has been more difficult to achieve is translating improvement in communication to other outcomes, such as improved hypertension or diabetes control. Most studies of communication interventions that have looked for effects beyond improvement in satisfaction have found no benefit.1, 2, 3 This is surprising since improvement in communication can lead to improved adherence to treatment regimens4, 5, 6 and adherence has been shown to be critical to improvement in some outcomes, such as blood pressure control.7

I once attended a “Meet the Professor” session at the annual Society of General Internal Medicine with Shelly Greenfield. The room was full of young researchers, all eager to push the field of patient-provider communication forward and looking forward to his guidance....

Notes

Compliance with Ethical Standards

Conflict of Interest

The author declares that he does not have a conflict of interest.

References

  1. 1.
    Jackson JL. A Randomized Trial to Improve Communication between Patients and Providers in a Primary Care Walk-in Clinic. J Gen Intern Med. 2018. 33(4):404–405.CrossRefGoogle Scholar
  2. 2.
    Frosch DL, Rincon D, Ochoa S, Mangione CM. Activating seniors to improve chronic disease care: results from a pilot intervention study. J Am Geriatr Soc 2010; 58(8):1496–1503.CrossRefGoogle Scholar
  3. 3.
    Griffin SJ, Kinmonth AL, Veltman MW, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med 2004; 2(6):595–608.CrossRefGoogle Scholar
  4. 4.
    Roter DL, Hall JA. Communication and adherence: moving from prediction to understanding. Med Care 2009; 47(8):823–825.CrossRefGoogle Scholar
  5. 5.
    Schneider J, Kaplan SH, Greenfield S, Li W, Wilson IB. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med 2004; 19(11):1096–1103.CrossRefGoogle Scholar
  6. 6.
    Lee SQ, Raamkumar AS, Li J, Cao Y, Witedwittayanusat K, Chen L, Theng YL. Reasons for Primary Medication Nonadherence: A Systematic Review and Metric Analysis. J Manag Care Spec Pharm. 2018;24(8):778–794.PubMedGoogle Scholar
  7. 7.
    Kronish IM, Moise N, McGinn T, Quan Y, Chaplin W, Gallagher BD, Davidson KW. An Electronic Adherence Measurement Intervention to Reduce Clinical Inertia in the Treatment of Uncontrolled Hypertension: The MATCH Cluster Randomized Clinical Trial. J Gen Intern Med. 2016;31(11):1294–1300.CrossRefGoogle Scholar
  8. 8.
    Greenfield S, Kaplan SH, Ware JE Jr, Yano EM, Frank HJ. Patients' participation in medical care: effects on blood sugar control and quality of life in diabetes. J Gen Intern Med 1988; 3(5):448–457.CrossRefGoogle Scholar
  9. 9.
    Vo MT, Uratsu CS, Estacio KR, Altschuler A, Kim E, Alexeeff SE, Adams AS, Schmittdiel JA, Heisler M, Grant RW. Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: A Pragmatic Cluster Randomized Trial. J Gen Intern Med.  https://doi.org/10.1007/s11606-018-4756-4
  10. 10.
    Greene J, Hibbard JH. Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med 2012; 27(5):520–526.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  1. 1.Zablocki VAMCMilwaukeeUSA

Personalised recommendations