Patient–provider communication, self-reported medication adherence, and race in a postmyocardial infarction population

Abstract

ObjectivesOur objectives were to: 1) describe patient-reported communication with their provider and explore differences in perceptions of racially diverse adherent versus nonadherent patients; and 2) examine whether the association between unanswered questions and patient-reported medication nonadherence varied as a function of patients’ race.MethodsWe conducted a cross-sectional analysis of baseline in-person survey data from a trial designed to improve postmyocardial infarction management of cardiovascular disease risk factors.ResultsOverall, 298 patients (74%) reported never leaving their doctor’s office with unanswered questions. Among those who were adherent and nonadherent with their medications, 183 (79%) and 115 (67%) patients, respectively, never left their doctor’s office with unanswered questions. In multivariable logistic regression, although the simple effects of the interaction term were different for patients of nonminority race (odds ratio [OR]: 2.16; 95% confidence interval [CI]: 1.19–3.92) and those of minority race (OR: 1.19; 95% CI: 0.54–2.66), the overall interaction effect was not statistically significant (P=0.24).ConclusionThe quality of patient–provider communication is critical for cardiovascular disease medication adherence. In this study, however, having unanswered questions did not impact medication adherence differently as a function of patients’ race. Nevertheless, there were racial differences in medication adherence that may need to be addressed to ensure optimal adherence and health outcomes. Effort should be made to provide training opportunities for both patients and their providers to ensure strong communication skills and to address potential differences in medication adherence in patients of diverse backgrounds.

Patient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States

“…[3][4][5][6][7][8] However, to date, there is little information on its relationship with a wide range of healthcare outcomes of interest. In this study, we determine the association of PPC on patient-reported health status, measures of quality of care, healthcare resource utilization, and spending for a nationally representative sample of adults with established ASCVD in the United States.…”

Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study

“…Researchers suggest that patient knowledge, self-monitoring, counseling, accountability, and a personalized program can contribute to improvement in medication adherence [ 52 ]. Experts and multiple stakeholders in medication adherence agree that a patient-centered approach is necessary, and increasing patient knowledge is critically important [ 25 ].…”

“…Experts and multiple stakeholders in medication adherence agree that a patient-centered approach is necessary, and increasing patient knowledge is critically important [ 25 ]. Technological solutions have been suggested to alleviate medication nonadherence, such as mHealth technology, electronic monitors, pill-monitoring technology, online resources, and social media [ 52 ]. The best manner to engage with Veterans via text messaging and mobile apps has yet to be determined among those of different ages, sexes, chronic diseases, mobile phone usage patterns, and ethnic populations.…”

Analyzing cardiovascular treatment guidelines application to women and minority populations

“…The quality of patient–provider communication may directly affect patient adherence to treatment. Zullig et al 44 studied the perception of provider communication in a racially diverse group of adherent and nonadherent post-MI patients and asked whether the association of having unanswered questions with nonadherence varied by patients’ race. Overall, among the 405 patients in their sample, 232 (57.3%) were adherent, but only 63 of 140 (45%) minority patients were adherent.…”