Patient-provider communication in nephrology care for adolescents and young adults.

The study observed single visits at one time point, so it cannot show how communication changes within the same patient over years. The analyses were exploratory and not adjusted for the chance that many tests can produce false positives. The study counted talk categories but did not measure health outcomes, adherence, satisfaction, or transition success. Provider talk did not vary by patient age, so the study cannot tell whether providers could or should change their communication. About half the visits included more than one provider, which may not match primary care visits. Only one coder used the RIAS system, and RIAS counts talk categories rather than analyzing conversation content or discourse. The sample required a caregiver to be present and excluded patients who could not comprehend spoken English, were pregnant, had certain developmental delays, were on dialysis or transferred care, had a kidney transplant less than 6 months before, or were not established patients. Psychosocial talk was low-frequency, and the sample may have been too small to detect differences in it.

Debra Roter is the author of the Roter Interaction Analysis System and holds its copyright; Johns Hopkins University has rights to some enhancements. The text states neither collects royalties for use of the system in research. Debra Roter is an owner of RIASWorks LLC, a company that provides RIAS coding services for non-university projects, and it is possible that RIASWorks would benefit indirectly from dissemination. All other authors declared no conflicts.

Do not read the age differences as proof that communication improves health outcomes or that providers automatically adapt as patients mature. The study was cross-sectional, measured talk rather than outcomes, and found no age-related change in provider talk.