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Chareonthaitawee P, Bullock-Palmer RP, Calnon DA, Gomez Valencia JA, Malhotra S, Polk DM, Phillips L, Sciammarella MG, Thompson RC, Mieres JH. The American Society of Nuclear Cardiology Diversity, Equity, and Inclusion mission statement. J Nucl Cardiol 2023; 30:1254-1257. [PMID: 36972000 DOI: 10.1007/s12350-023-03238-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/29/2023]
Affiliation(s)
| | | | | | | | | | - Donna M Polk
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
| | - Lawrence Phillips
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Maria G Sciammarella
- Division of Cardiology, Zuckerberg San Francisco General Hospital, UCSF, San Francisco, CA, USA
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute and the University of Missouri - Kansas City, Kansas City, MO, USA
| | - Jennifer H Mieres
- Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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2
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Provance JB, Spertus JA, Jones PG, Hoffman MA, Bunte MC, Vogel TR, Mena-Hurtado C, Smolderen KG. Variability in 30-day major amputation rates following endovascular peripheral vascular intervention for critical limb ischemia. Vasc Med 2022; 27:350-357. [PMID: 35603755 DOI: 10.1177/1358863x221098097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Patients with critical limb ischemia (CLI) can undergo endovascular peripheral vascular intervention (PVI) to restore blood flow and decrease risk of amputation. As a potential indicator of quality for CLI care, we sought to describe 30-day major amputation rates following PVI. We also examined rate variability, and patient-level and site-level factors predicting amputations, using a national electronic health record (EHR) database. Methods: Using the Cerner Health Facts de-identified EHR database, patients with CLI diagnosis codes undergoing PVI were identified. The rate of amputation within 30 days of PVI was calculated. Risk ratios predicting amputation were derived using a mixed effects Poisson regression model adjusting for 16 patient and clinical factors. Median risk ratios (MRRs) were calculated to quantify site-level variability in amputations. Results: A total of 20,204 PVI procedures for CLI from 179 healthcare sites were identified. Mean age at procedure was 69.0 ± 12.6 years, 58.0% were male, and 29.6% were persons of color. Amputation within 30 days of PVI occurred after 570 (2.8%) procedures. Malnutrition, previous amputation, diabetes, and being of Black race were predictors of amputation. Amputation rates across sites ranged from 0.0% to 10.0%. The unadjusted MRR was 1.40 (95% CI 1.35-1.46), which was attenuated after adjusting for patient-level factors (MRR 1.30, 95% CI 1.26-1.34) and site characteristics (MRR 1.11, 95% CI 1.09-1.13). Conclusions: Among PVI procedures for CLI treatment, 30-day amputation rates varied across institutions. Although patient-level factors explained some variability, site-level factors explained most variation in the rates of these outcomes.
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Affiliation(s)
- Jeremy B Provance
- Vascular Medicine Outcomes (VAMOS) Research Group, Department of Internal Medicine, Cardiovascular Medicine Section, Yale University, New Haven, CT, USA
| | - John A Spertus
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.,Saint Luke's Mid-America Heart Institute, Kansas City, MO, USA
| | - Philip G Jones
- Saint Luke's Mid-America Heart Institute, Kansas City, MO, USA
| | - Mark A Hoffman
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.,Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA
| | - Matthew C Bunte
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.,Saint Luke's Mid-America Heart Institute, Kansas City, MO, USA
| | - Todd R Vogel
- Division of Vascular Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Carlos Mena-Hurtado
- Vascular Medicine Outcomes (VAMOS) Research Group, Department of Internal Medicine, Cardiovascular Medicine Section, Yale University, New Haven, CT, USA
| | - Kim G Smolderen
- Vascular Medicine Outcomes (VAMOS) Research Group, Department of Internal Medicine, Cardiovascular Medicine Section, Yale University, New Haven, CT, USA.,Department of Psychiatry, Yale University, New Haven, CT, USA
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3
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Tamirisa KP, Al-Khatib SM, Mohanty S, Han JK, Natale A, Gupta D, Russo AM, Al-Ahmad A, Gillis AM, Thomas KL. Racial and Ethnic Differences in the Management of Atrial Fibrillation. CJC Open 2021; 3:S137-S148. [PMID: 34993443 PMCID: PMC8712595 DOI: 10.1016/j.cjco.2021.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/03/2021] [Indexed: 01/24/2023] Open
Abstract
Atrial fibrillation (AF) is the most common clinical arrhythmia, and it results in adverse outcomes and increased healthcare costs. Racial and ethnic differences in AF management, although recognized, are poorly understood. This review summarizes racial differences in AF epidemiology, genetics, clinical presentation, and management. In addition, it highlights the underrepresentation of racial and ethnic populations in AF clinical trials, especially trials focused on stroke prevention. Specific strategies are proposed for future research and initiatives that have potential to eliminate racial and ethnic differences in the care of patients with AF. Addressing racial and ethnic disparities in healthcare access, enrollment in clinical trials, resource allocation, prevention, and management will likely narrow the gaps in the care and outcomes of racial and ethnic minorities suffering from AF.
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Affiliation(s)
| | - Sana M. Al-Khatib
- Division of Cardiology, Duke University Medical Centre, Durham, North Carolina, USA
| | | | - Janet K. Han
- Division of Cardiology, Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, California, USA
- University of California Los Angeles School of Medicine, Los Angeles, California, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, Austin/Dallas, Texas, USA
| | - Dhiraj Gupta
- Department of Cardiology, University of Liverpool, London, United Kingdom
| | - Andrea M. Russo
- Division of Cardiology, Cooper University Hospital, Camden, New Jersey, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, Austin/Dallas, Texas, USA
| | - Anne M. Gillis
- Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kevin L. Thomas
- Division of Cardiology, Duke University Medical Centre, Durham, North Carolina, USA
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4
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Sentell T, Foss-Durant A, Patil U, Taira D, Paasche-Orlow MK, Trinacty CM. Organizational Health Literacy: Opportunities for Patient-Centered Care in the Wake of COVID-19. Qual Manag Health Care 2021; 30:49-60. [PMID: 33229999 DOI: 10.1097/qmh.0000000000000279] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease-2019 (COVID-19) pandemic is transforming the health care sector. As health care organizations move from crisis mobilization to a new landscape of health and social needs, organizational health literacy offers practical building blocks to provide high-quality, efficient, and meaningful care to patients and their families. Organizational health literacy is defined by the Institute of Medicine as "the degree to which an organization implements policies, practices, and systems that make it easier for people to navigate, understand, and use information and services to take care of their health." METHODS This article synthesizes insights from organizational health literacy in the context of current major health care challenges and toward the goal of innovation in patient-centered care. We first provide a brief overview of the origins and outlines of organizational health literacy research and practice. Second, using an established patient-centered innovation framework, we show how the existing work on organizational health literacy can offer a menu of effective, patient-centered innovative options for care delivery systems to improve systems and outcomes. Finally, we consider the high value of management focusing on organizational health literacy efforts, specifically for patients in health care transitions and in the rapid transformation of care into myriad distance modalities. RESULTS This article provides practical guidance for systems and informs decisions around resource allocation and organizational priorities to best meet the needs of patient populations even in the face of financial and workforce disruption. CONCLUSIONS Organizational health literacy principles and guidelines provide a road map for promoting patient-centered care even in this time of crisis, change, and transformation. Health system leaders seeking innovative approaches can have access to well-established tool kits, guiding models, and materials toward many organizational health literacy goals across treatment, diagnosis, prevention, education, research, and outreach.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii (Dr Sentell and Mr Patil); Arizona State University Edson College of Nursing and Healthcare Innovations, Phoenix (Ms Foss-Durant); The Daniel K. Inouye College of Pharmacy, Hilo, Hawaii (Dr Taira); Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts (Dr Paasche-Orlow); and Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Dr Trinacty)
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5
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Gurewich D, Garg A, Kressin NR. Addressing Social Determinants of Health Within Healthcare Delivery Systems: a Framework to Ground and Inform Health Outcomes. J Gen Intern Med 2020; 35:1571-1575. [PMID: 32076989 PMCID: PMC7210348 DOI: 10.1007/s11606-020-05720-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/24/2019] [Accepted: 02/04/2020] [Indexed: 01/08/2023]
Abstract
Social determinants of health (SDoH) are the conditions in which people live and work that shape access to essential social and economic resources. Calls for healthcare systems to intervene on unmet social needs have stimulated several large-scale initiatives across the country. Yet, such activities are underway in the absence of a unifying conceptual framework outlining the potential mechanisms by which healthcare-based unmet social need interventions can improve health outcomes. Drawing on theoretical foundations and empirical evidence about the relationship between unmet social needs and health, the authors developed the OASIS (Outcomes from Addressing SDoH in Systems) conceptual framework to map the known and hypothesized pathways by which unmet social need screening and referral interventions may impact outcomes. The OASIS framework may help guide policy makers, healthcare system leaders, clinicians, and researchers to utilize a more unified approach in their efforts to implement and evaluate unmet social need interventions and thus foster the development of an evidence base to inform healthcare systems to more effectively mitigate the consequences of unmet social needs. Adopting an overarching conceptual framework for addressing unmet social needs by healthcare systems holds promise for better achieving health equity and promoting health at the individual and population levels.
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Affiliation(s)
- Deborah Gurewich
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, MA, USA. .,Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
| | - Arvin Garg
- Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Nancy R Kressin
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, MA, USA.,Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
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6
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Implementing an EHR-based Screening and Referral System to Address Social Determinants of Health in Primary Care. Med Care 2020; 57 Suppl 6 Suppl 2:S133-S139. [PMID: 31095052 DOI: 10.1097/mlr.0000000000001029] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Social determinants affect health, yet there are few systematic clinical strategies in primary care that leverage electronic health record (EHR) automation to facilitate screening for social needs and resource referrals. An EHR-based social determinants of health (SDOH) screening and referral model, adapted from the WE CARE model for pediatrics, was implemented in urban adult primary care. OBJECTIVES This study aimed to: (1) understand the burden of SDOH among patients at Boston Medical Center; and (2) evaluate the feasibility of implementing a systematic clinical strategy to screen new primary care patients for SDOH, use EHR technology to add these needs to the patient's chart through autogenerated ICD-10 codes, and print patient language-congruent referrals to available resources upon patient request. RESEARCH DESIGN This observational study assessed the number of patients who were screened to be positive and requested resources for social needs. In addition, we evaluated the feasibility of implementing our SDOH strategy by determining the proportion of: eligible patients screened, providers signing orders for positive patient screenings, and provider orders for resource referral guides among patients requesting resource connections. RESULTS In total, 1696 of 2420 (70%) eligible patients were screened. Employment (12%), food insecurity (11%), and problems affording medications (11%) were the most prevalent concerns among respondents. In total, 367 of 445 (82%) patients with ≥1 identified needs (excluding education) had the appropriate ICD-10 codes added to their visit diagnoses. In total, 325 of 376 (86%) patients who requested resources received a relevant resource referral guide. CONCLUSIONS Implementing a systematic clinical strategy in primary care using EHR workflows was successful in identifying and providing resource information to patients with SDOH needs.
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Kressin NR, Elwy AR, Glickman M, Orner MB, Fix GM, Borzecki AM, Katz LA, Cortés DE, Cohn ES, Barker A, Bokhour BG. Beyond Medication Adherence: The Role of Patients' Beliefs and Life Context in Blood Pressure Control. Ethn Dis 2019; 29:567-576. [PMID: 31641324 DOI: 10.18865/ed.29.4.567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective Despite numerous interventions to address adherence to antihypertensive medications, continued high rates of uncontrolled blood pressure (BP) suggest a need to better understand patient factors beyond adherence associated with BP control. We examined how patients' BP-related beliefs, and aspects of life context affect BP control, beyond medication adherence. Methods We conducted a cross-sectional telephone survey of primary care patients with hypertension between 2010 and 2011 (N=103; 93 had complete data on all variables and were included in the regression analyses). We assessed patient sociodemographics (including race/ethnicity), medication adherence, BP-related beliefs, aspects of life context, and used clinical BP assessments. Results Regression models including sociodemographics, medication adherence, and either beliefs or context consistently predicted BP control. Adding context after beliefs added no predictive value while adding beliefs after context significantly predicted BP control. Practical Implications Results suggest that when clinicians must choose a dimension on which to intervene, focusing on beliefs would be the most fruitful approach to effecting change in BP control.
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Affiliation(s)
- Nancy R Kressin
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Section of General Internal Medicine, Boston University School of Medicine; Boston, MA
| | - A Rani Elwy
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University; Providence, RI
| | - Mark Glickman
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Department of Statistics, Harvard University; Boston, MA
| | - Michelle B Orner
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA
| | - Gemmae M Fix
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Boston University School of Public Health; Boston, MA
| | - Ann M Borzecki
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Section of General Internal Medicine, Boston University School of Medicine; Boston, MA.,Boston University School of Public Health; Boston, MA
| | - Lois A Katz
- VA New York Harbor Healthcare System; New, York, NY.,New York University School of Medicine; New York, NY
| | - Dharma E Cortés
- Cambridge Health Alliance; Cambridge, MA.,Harvard Medical School; Cambridge, MA
| | - Ellen S Cohn
- Boston University, Sargent College of Health and Rehabilitation Sciences; Boston, MA
| | - Anna Barker
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA
| | - Barbara G Bokhour
- Center for Healthcare Organization and Implementation Research (CHOIR), a VA HSR&D Center of Innovation, VA Boston Healthcare System and Edith Nourse Rogers Memorial Veterans Hospital; Bedford, MA.,Boston University School of Public Health; Boston, MA
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8
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Kamimura A, Weaver S, Armenta B, Gull B, Ashby J. Patient centeredness: The perspectives of uninsured primary care patients in the United States. INTERNATIONAL JOURNAL OF CARE COORDINATION 2019. [DOI: 10.1177/2053434519836424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction Patient-centered care has become increasingly important within the United States (US) healthcare system. Given that patient-centered care predicts patient satisfaction, health outcomes, and cost-effectiveness, it is of the utmost importance to study patient-centered care from the perspectives of marginalized populations including minorities, immigrants, and other underserved populations. The purpose of this study is to examine factors that affect underserved primary care patients’ perceptions of patient centeredness. Methods The data were cross-sectional and collected in Fall 2016. Free clinic patients (N = 723) completed a self-administered survey, which measures patient centeredness, patient involvement in care, and clinical empathy. Validated measures were part of the survey, and the internal consistency of scales was tested. The general linear model was performed to predict factors associated with patients’ perceptions of patient centeredness. Results Higher levels of perceived patient involvement in care and higher levels of perceived empathy in consultation are related to higher levels of patient centeredness. While better physical health is associated with higher levels of perceived empathy in consultation, high levels of emotional health and depression are not. Conclusions Patients’ perceptions of involvement and empathy are important factors for patient-centered care, although this study did not show causal directions among variables. Based on the findings of this study, it is recommended that future studies should focus on the following three points: (1) to develop and evaluate trainings for providers, (2) develop education classes for patients who utilize free clinics, (3) analyze how these programs affect patient-centered care and health outcomes.
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9
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Cantor MN, Chandras R, Pulgarin C. FACETS: using open data to measure community social determinants of health. J Am Med Inform Assoc 2019; 25:419-422. [PMID: 29092049 DOI: 10.1093/jamia/ocx117] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/23/2017] [Indexed: 02/01/2023] Open
Abstract
Objective To develop a dataset based on open data sources reflective of community-level social determinants of health (SDH). Materials and Methods We created FACETS (Factors Affecting Communities and Enabling Targeted Services), an architecture that incorporates open data related to SDH into a single dataset mapped at the census-tract level for New York City. Results FACETS (https://github.com/mcantor2/FACETS) can be easily used to map individual addresses to their census-tract-level SDH. This dataset facilitates analysis across different determinants that are often not easily accessible. Discussion Wider access to open data from government agencies at the local, state, and national level would facilitate the aggregation and analysis of community-level determinants. Timeliness of updates to federal non-census data sources may limit their usefulness. Conclusion FACETS is an important first step in standardizing and compiling SDH-related data in an open architecture that can give context to a patient's condition and enable better decision-making when developing a plan of care.
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Affiliation(s)
- Michael N Cantor
- Department of Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA.,Medical Center Information Technology, NYU Langone Health, New York, NY, USA
| | - Rajan Chandras
- Medical Center Information Technology, NYU Langone Health, New York, NY, USA
| | - Claudia Pulgarin
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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10
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Schoenthaler A, Knafl GJ, Fiscella K, Ogedegbe G. Addressing the Social Needs of Hypertensive Patients: The Role of Patient-Provider Communication as a Predictor of Medication Adherence. Circ Cardiovasc Qual Outcomes 2018; 10:CIRCOUTCOMES.117.003659. [PMID: 28830861 DOI: 10.1161/circoutcomes.117.003659] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/27/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Poor medication adherence is a pervasive problem in patients with hypertension. Despite research documenting an association between patient-provider communication and medication adherence, there are no empirical data on how the informational and relational aspects of communication affect patient's actual medication-taking behaviors. The aim of this study was to evaluate the impact of patient-provider communication on medication adherence among a sample of primary care providers and their black and white hypertensive patients. METHODS AND RESULTS Cohort study included 92 hypertensive patients and 27 providers in 3 safety-net primary care practices in New York City. Patient-provider encounters were audiotaped at baseline and coded using the Medical Interaction Process System. Medication adherence data were collected continuously during the 3-month study with an electronic monitoring device. The majority of patients were black, 58% women, and most were seeing the same provider for at least 1 year. Approximately half of providers were white (56%), 67% women, and have been in practice for an average of 5.8 years. Fifty-eight percent of patients exhibited poor adherence to prescribed antihypertensive medications. Three categories of patient-provider communication predicted poor medication adherence: lower patient centeredness (odds ratio: 3.08; 95% confidence interval: 1.04-9.12), less discussion about patients' sociodemographic circumstances (living situation, relationship with partner; odds ratio: 6.03; 95% confidence interval: 2.15-17), and about their antihypertensive medications (odds ratio: 6.48; 95% confidence interval: 1.83-23.0). The effect of having less discussion about patients' sociodemographic circumstances on medication adherence was heightened in black patients (odds ratio: 8.01; 95% confidence interval: 2.80-22.9). CONCLUSIONS The odds of poor medication adherence are greater when patient-provider interactions are low in patient centeredness and do not address patients' sociodemographic circumstances or their medication regimen.
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Affiliation(s)
- Antoinette Schoenthaler
- From the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.).
| | - George J Knafl
- From the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.)
| | - Kevin Fiscella
- From the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.)
| | - Gbenga Ogedegbe
- From the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.)
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11
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Mosher HJ, Lyckholm LJ. A problem of capacity, but whose? The hospitalists' discharge dilemma and social determinants of health. J Hosp Med 2017; 12:57-58. [PMID: 28125833 DOI: 10.1002/jhm.2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Hilary J Mosher
- Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Laurel J Lyckholm
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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