Zeng Jianwei, Gao Yuqiang, Hou Chen, Liu Tao
Department of Cardiovascular Medicine, The Central Hospital of Yongzhou, University of South China, Yongzhou, Hunan, China.
Department of Clinical Laboratory, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China.
PeerJ. 2024 Nov 28;12:e18527. doi: 10.7717/peerj.18527. eCollection 2024.
This systematic review aims to present existing evidence concerning the effects of doctor-patient communication on medication adherence and blood pressure control in hypertensive patients.
Two researchers independently conducted comprehensive searches of five databases and screened relevant studies published from the inception of these databases up to July 21, 2024. The titles, abstracts, and full texts of all the retrieved articles subsequently underwent rigorous duplicate screening, according to predefined inclusion and exclusion criteria. We then synthesized the findings in a narrative format of the included studies. Finally, two researchers independently assessed study quality.
Eighteen observational studies encompassing 21,542 patients and seven randomized controlled trials with 2,804 patients were included in the systematic review. Diverse approaches were employed for evaluating doctor-patient communication and medication adherence in these studies, with identified themes including communication content and communication skills. Various facets of doctor-patient communication, including patient satisfaction with doctor-patient communication, the specific content discussed, the style of communication, the comprehensive communication skills of doctors, and the duration of these conversations, were scrutinized. In general, the results suggest a promising link between effective doctor-patient communication and increased medication adherence and blood pressure control. Nonetheless, the presence of nuanced variations and subtle distinctions within the literature underscores the imperative for deeper exploration and consideration in clinical practice. Additionally, effective communication interventions must attain a certain threshold of intensity and endure for an adequate duration.
This review underscores the pivotal role of robust doctor-patient communication in improving both medication adherence and blood pressure control. Nevertheless, additional research may be warranted to address the disparities and subtleties in the literature and to establish precise implications for clinical practice. Moreover, in clinical practice, strategies to enhance doctor-patient communication should be incorporated, given the potential to improve medication adherence and blood pressure control among hypertensive patients.
Systematic review registration: PROSPERO with registration number CRD42024503112.
本系统评价旨在呈现关于医患沟通对高血压患者药物依从性和血压控制影响的现有证据。
两名研究人员独立对五个数据库进行全面检索，并筛选从这些数据库建立之初至2024年7月21日发表的相关研究。随后，根据预先定义的纳入和排除标准，对所有检索到的文章的标题、摘要和全文进行严格的重复筛选。然后，我们以纳入研究的叙述形式综合研究结果。最后，两名研究人员独立评估研究质量。
该系统评价纳入了18项观察性研究（涉及21542名患者）和7项随机对照试验（涉及2804名患者）。这些研究采用了多种方法来评估医患沟通和药物依从性，确定的主题包括沟通内容和沟通技巧。对医患沟通的各个方面进行了审查，包括患者对医患沟通的满意度、讨论的具体内容、沟通方式、医生的综合沟通技巧以及这些对话的时长。总体而言，结果表明有效的医患沟通与提高药物依从性和血压控制之间存在有前景的联系。尽管如此，文献中存在细微的差异和微妙的区别，这凸显了在临床实践中进行更深入探索和考虑的必要性。此外，有效的沟通干预必须达到一定的强度阈值并持续足够的时长。
本综述强调了强有力的医患沟通在改善药物依从性和血压控制方面的关键作用。然而，可能需要更多研究来解决文献中的差异和微妙之处，并确定对临床实践的确切影响。此外，在临床实践中应纳入增强医患沟通的策略，因为这有可能改善高血压患者的药物依从性和血压控制。
系统评价注册：PROSPERO，注册号CRD42024503112。
