Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland, USA.
Popul Health Manag. 2021 Oct;24(5):581-588. doi: 10.1089/pop.2020.0290. Epub 2021 Jan 7.
High cholesterol is a preventable risk factor for heart disease. This study examines which aspects of patient-provider communication are associated with patient report of increased adherence to cholesterol management advice in a diverse, low-income patient population accessing the health care safety net, using the 2014 Health Center Patient Survey. Patient-provider communication measures included patient report of: how often a provider listened carefully, gave easy-to-understand information, knew important information about the patient's medical history, showed respect, and spent enough time with the patient. Outcome measures were patient report of following provider advice to eat fewer high fat or high cholesterol foods, manage weight, increase physical activity, or take prescribed medicine. In adjusted analyses, when patients perceived their provider always knew their medical history, patients were more likely to report taking prescribed medication (adjusted odds ratio [aOR]: 3.2; 95% confidence interval [CI]: 1.6, 6.6). Knowledge of medical history (aOR: 2.8, 95% CI: 1.4, 5.8), spending enough time (aOR: 2.3, 95% CI: 1.2, 4.4), and providing easily understandable information (aOR: 2.2, 95% CI: 1.0, 4.7) were significantly associated with report of following physical activity advice. Knowledge of medical history (aOR: 2.3, 95% CI: 1.0, 5.2) and providing easily understandable information (aOR: 3.3, 95% CI: 1.4, 7.9) were significantly associated with report of following weight management advice. This study indicates different components of patient-provider communication influence patient adherence to lifestyle modification advice and medication prescription. These results suggest a tailored approach to optimize the impact of patient-provider communication on cholesterol management advice adherence.
高胆固醇是心脏病的可预防风险因素。本研究使用 2014 年健康中心患者调查，检查了在访问医疗保障网的多样化低收入患者群体中，哪些患者与提供者沟通的方面与患者报告增加对胆固醇管理建议的依从性有关，这些沟通措施包括患者报告提供者：是否经常仔细倾听、提供易于理解的信息、了解患者病史的重要信息、表现出尊重以及与患者相处的时间是否足够。结果衡量指标是患者报告遵循医生建议减少食用高脂肪或高胆固醇食物、控制体重、增加身体活动或服用规定药物的情况。在调整分析中，当患者认为他们的医生总是了解他们的病史时，他们更有可能报告服用规定的药物（调整后的优势比 [aOR]：3.2；95%置信区间 [CI]：1.6，6.6）。了解病史（aOR：2.8，95% CI：1.4，5.8）、花足够的时间（aOR：2.3，95% CI：1.2，4.4）和提供易于理解的信息（aOR：2.2，95% CI：1.0，4.7）与报告遵循体育锻炼建议显著相关。了解病史（aOR：2.3，95% CI：1.0，5.2）和提供易于理解的信息（aOR：3.3，95% CI：1.4，7.9）与报告遵循体重管理建议显著相关。本研究表明，患者与提供者沟通的不同组成部分会影响患者对生活方式改变建议和药物处方的依从性。这些结果表明，需要采取有针对性的方法来优化患者与提供者沟通对胆固醇管理建议依从性的影响。
