Physician–patient communication in rheumatology: a systematic review

Abstract

The nature of physician–patient interaction can have a significant impact on patient outcomes through information-sharing and disease-specific education that can enhance patients’ active involvement in their care. The aim of this systematic review was to examine all the empirical evidence pertaining to aspects of physician–patient communication and its impact on patient outcomes. A systematic search of five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL, and Web of Science) was undertaken from earliest record to December 2016. Studies were eligible if they: (1) included adult participants (18 years or over) with a diagnosis of a rheumatic condition; (2) were of quantitative, qualitative or mixed methods design; (4) were surveys, observational and interventional studies; (5) were published in the English language; and (6) reported findings on either various physician–patient communication aspects alone or in combination with physical and psychological outcomes. Searches identified 455 papers. Following full-text retrieval and assessment for eligibility and quality, ten studies were included in the review; six quantitative, one mixed methods, and three qualitative papers. Higher levels of trust in the physician and active patient participation in the medical consultation were linked to lower disease activity, better global health, less organ damage accrual, greater treatment satisfaction with fewer side effects from the medication, more positive beliefs about control over the disease, and about current and future health. Future research could focus on the design and implementation of interventions incorporating communications skills and patient-education training.

Integrating patient perspectives in medical decision-making: a qualitative interview study examining potentials within the rare disease information exchange process in practice

“…The analysis revealed an imbalance between trust and mistrust in the rare disease field, whereby a trusting patient-physician relationship is a prerequisite for effective communication. Georgopoulou, Prothero, and D’Cruz [35], Dowell et al [13], and the Royal Pharmaceutical Society of Great Britain, Merck, Sharp, and Dohme [14] all link a trusting relationship with a physician to many positive healthcare outcomes. Von der Lippe, Diesen, and Feragen [36] further deepen this analysis by describing a mistrust of doctors, and linking this to patients’ emotional reactions.…”

Rapport: Little effect on children’s, adolescents’, and adults’ statement quantity, accuracy, and suggestibility

“…Clearly, the concept has been successfully employed across different disciplines including medical science, psychotherapy, and learning environments (i.e., schools and university). In these fields, evidence for the positive effects of good patientphysician, patient-therapist, and student-teacher working alliance on clinical, psychological treatment, and learning outcomes are accumulating (e.g., Derksen, Bensing, & Lagro-Janssen, 2013;Fuertes, Toporovsky, Reyes, & Osborne, 2017;Georgopoulou, Prothero, & D'Cruz, 2018;Horvath, Del Re, Fluckiger, & Symonds, 2011;Rogers, 2015;van Osch, van Dulmen, van Vliet, & Bensing, 2017). Thus, the status quo should inspire researchers to systematically approach the issue of rapport building in witness interviews in different age groups, testing the isolated and combined effects of different rapport building components (cf.…”

Is it me? The impact of patient–physician interactions on lupus patients’ psychological well-being, cognition and health-care-seeking behaviour

“…Georgopoulou et al . [ 13 ] carried out a recent systematic review and concluded that more research was required to increase understanding of the patient–physician relationship in rheumatology. The physician–patient relationship is vital, because it has an impact on patient outcomes and satisfaction with treatment and care [ 13 ] and on various behaviours, although only medication adherence has been studied in any depth [ 13 , 14 ].…”