Patient-Doctor Communication Affects Medication Adherence

Poorer communication ratings tied to lower adherence, especially for hypoglycemic medications

FRIDAY, Jan. 4 (HealthDay News) -- Poor communication between patients and health care providers is linked to lower cardiometabolic medication adherence, according to a study published online Dec. 31 in JAMA Internal Medicine.

Neda Ratanawongsa, M.D., M.P.H., from the University of California in San Francisco, and colleagues analyzed data from 9,377 patients in the Diabetes Study of Northern California, a race-stratified, random sample of Kaiser Permanente survey respondents. In the 12 months preceding the survey, the patients received one or more oral hypoglycemic, lipid-lowering, or antihypertensive medication. Communication with their health care provider was measured with the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) score and four items from the Trust in Physicians and Interpersonal Processes of Care instruments. Greater than a 20 percent continuous medication gap for ongoing medication therapies was used to define poor adherence.

The researchers found that 30 percent of participants had poor cardiometabolic medication refill adherence. The adjusted prevalence of poor adherence increased by 0.9 percent (P = 0.01) for each 10-point decrease in CAHPS score. Patients who gave health care providers lower ratings for involving patients in decisions, understanding patients' problems with treatment, and eliciting confidence and trust were more likely to have poor adherence, compared with patients giving higher ratings to their physicians. Hypoglycemic medications had higher associations between communication and adherence than did other medications.

"Poor communication ratings were independently associated with objectively measured inadequate cardiometabolic medication refill adherence, particularly for oral hypoglycemic medications," the authors write.

Abstract
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