Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
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.
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.
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.
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.
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 10). https://acrabstracts.org/abstract/a-pan-canadian-study-of-factors-associated-with-perceived-doctor-patient-communication-in-patients-with-systemic-lupus-erythematosus/. Accessed May 30, 2020.
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