ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2342

A Pan-Canadian Study of Factors Associated with Perceived Doctor-Patient Communication in Patients with Systemic Lupus Erythematosus

Deborah Da Costa1, Carolyn Neville2, Anne-Sophie Julien3, Murray Rochon4, Davy Eng5, Christine A. Peschken6, Evelyne Vinet7, C Douglas Smith8, Mark Matsos9, Janet E. Pope10, Ann E. Clarke11, Stephanie Keeling12, J. Antonio Avina-Zubieta13, Marie Hudson14 and Paul R. Fortin15, 1Medicine, McGill University, Montreal, QC, Canada, 2Department of Medicine, McGill University Health Center, Montreal, QC, Canada, 3CHU de Québec - Université Laval, Quebec City, QC, Canada, 4Jack Digital, Toronto, ON, Canada, 5Centre de recherche du CHU de Québec, Université Laval, Québec, QC, Canada, 6RR 149G, University of Manitoba, Winnipeg, MB, Canada, 7Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada, 8The Arthritis Centre, TOH Riverside Campus, Ottawa, ON, Canada, 9Medicine, McMaster University, Hamilton, ON, Canada, 10Department of Medicine, University of Western Ontario, London, ON, Canada, 11Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 12Department of Medicine, University of Alberta, University of Alberta, Edmonton, AB, Canada, 13Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada, 14Division of Rheumatology, Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, QC, Canada, 15Medicine, CHU de Québec - University of Laval, Quebec, QC, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Date: Tuesday, October 23, 2018

Title: Patient Outcomes, Preferences, and Attitudes Poster II: Patient Perspectives

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with fluctuating levels of disease activity, which may require frequent encounters with the medical system and complex treatment decisions. Doctor-patient communication is an important indicator of health-care quality, with better communication associated with higher health self-management and improved health outcomes. We describe perceptions of doctor-patient communication in lupus patients and the extent to which sociodemographic, disease related and depressive symptoms influence doctor-patient communication.

Methods:

Baseline data from patients in the Canadian Network for Improved Outcomes in SLE (CaNIOS) centers participating in the MyLupusGuideTM randomized clinical trial were analyzed. Consenting participants completed on-line questionnaires. Five subscales (eliciting concerns, general clarity, explaining results, decision-making, and compassionate interpersonal style) from the Interpersonal Processes of Care (IPC) instrument measured doctor-patient communication. Each subscale was dichotomized to reflect optimal or suboptimal communication, defined as a score of <4 (range 0 to 4). Self-reported data on demographic (age, sex, ethnicity), disease characteristics and depression were collected using validated measures. Descriptive statistics were performed and univariate logistic regressions estimated with a generalized linear mixed model examined factors associated with each IPC susbscale.

Results:

Baseline data were available for 532 of 1916 patients, with a mean (SD) age of 50 (14) years, 91% female and 74% self-identified as white. Optimal doctor-patient communication across the subscales ranged between 22.6-35.5%, with shared decision-making receiving the lowest and general clarity the highest ratings. Age (younger) was associated with suboptimal patient perceptions related to eliciting concerns (p=0.011) and explanation of test results during patient-doctor interactions (p=0.035). Shorter disease duration was associated with suboptimal ratings of general clarity (p=0.027) in doctor communication style. More males reported suboptimal communication related to general clarity (83.8%, p=0.017) and shared decision making (91.9%, p=0.042) compared to females (63.5%, 76.4%, respectively). A greater proportion of participants with depressive symptoms compared to non-depressed reported suboptimal ratings related to their doctor eliciting and responding to their concerns (78.4% vs. 68.2%, respectively; p=0.01), explaining test results (72.4% vs. 63.8%, p=0.04) and shared decision making (82.4% vs. 73.8%, p=0.02). None of the variables examined were associated with the compassionate interpersonal style subscale.

Conclusion:

Many lupus patients report suboptimal communication experiences with their doctor, with certain domains being more impacted for patients who are younger, with shorter disease duration, male and depressed. Further research into the factors associated with perceptions of poor communication in the clinical encounter and strategies to improve more patient-centred communication are needed.

Disclosure: D. Da Costa, None; C. Neville, None; A. S. Julien, None; M. Rochon, None; D. Eng, None; C. A. Peschken, None; E. Vinet, None; C. D. Smith, None; M. Matsos, None; J. E. Pope, None; A. E. Clarke, None; S. Keeling, None; J. A. Avina-Zubieta, None; M. Hudson, None; P. R. Fortin, None.

To cite this abstract in AMA style:

Da Costa D, Neville C, Julien AS, Rochon M, Eng D, Peschken CA, Vinet E, Smith CD, Matsos M, Pope JE, Clarke AE, Keeling S, Avina-Zubieta JA, Hudson M, Fortin PR. A Pan-Canadian Study of Factors Associated with Perceived Doctor-Patient Communication in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/a-pan-canadian-study-of-factors-associated-with-perceived-doctor-patient-communication-in-patients-with-systemic-lupus-erythematosus/. Accessed .

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