It takes two to tango: A dyadic approach to understanding the medication dialogue in patient-provider relationships.
Antoinette Schoenthaler, Melissa Basile, Tessa V West and 1 others
PMID 29478882WHAT IT FOUND
Four communication patterns emerged among hypertensive patients and their providers.
In interactive and convergent-traditional visits, providers set agenda, asked open questions, checked medication understanding, and problem-solved non-adherence. In disconnected visits, medication concerns were often left unaddressed.
Key findings
01The analysis produced four patient-provider communication typologies.
02In interactive and convergent-traditional exchanges, providers set agenda collaboratively, used open questions, assessed medication understanding, and problem-solved when patients admitted non-adherence.
03In divergent-traditional and disconnected exchanges, provider dominance with closed questions and directives made it hard for patients to clarify medical language or have medication concerns addressed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was mostly low-income African-American and White patients, so the patterns may not apply to other groups. Communication was observed at one time point, so it does not show how the patterns change over a long relationship. Only audio was recorded, so non-verbal cues and emotional state were not studied. The study describes patterns in recorded visits; it did not test whether changing communication improves adherence or blood pressure.
Declared interests
The authors declared no conflicts of interest. The article is listed as receiving N.I.H. extramural research support.
The easy way to misread this
Do not treat the four typologies as proof that changing communication improves adherence. This was an observational study of recorded visits. It did not test a communication intervention or measure patient outcomes.