Engagement and Affective Communication During Pediatric Nephrology Clinic Visits: Associations with Medication Adherence.
Trevor W Glenn, Kristin A Riekert, Debra Roter and 7 others
PMID 32948401WHAT IT FOUND
In adolescents and young adults with kidney disease, more AYA participation in clinic visits was linked to better blood pressure medication use after the visit.
Provider displays of anger or anxiety were linked to worse adherence. Other caregiver and provider factors showed no link.
Key findings
01Higher AYA engagement during the recorded clinic visit was associated with higher medication adherence after the visit.
02Provider displays of anger or anxiety during the visit were associated with lower medication adherence after the visit.
03Caregiver engagement, caregiver affect, AYA affect, provider engagement, and provider positive affect did not show a significant association with after-visit adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The final sample was small and came from clinics in one region, so it may not apply elsewhere. Communication was rated from audio recordings only, so body language and the context or target of statements were not included. Adherence was measured in short windows before and after the visit, not continuously, so events between measurements may have affected it. The study observed an established clinic visit, so it cannot show that communication caused adherence, or how earlier visits affected either. Many caregiver and provider factors showed no association, and the authors say the smaller sample may have limited power to detect effects.
Declared interests
The article is listed as supported by NIH extramural research funding. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that increasing AYA talk or reducing provider anger will improve medication adherence. This was an observational study of a clinic visit, not a test of a communication intervention, and many caregiver and provider factors were not associated with adherence.