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Chronic Care Diagnoses Need Better Patient-Provider Communication

Patient-provider communication at the time of a chronic care diagnosis can impact how the patient perceives the diagnosis, research indicates.

patient provider communication chronic care diagnosis

Source: Thinkstock

By Sara Heath

- When diagnosing a patient with a chronic illness, the way a clinician communicates with the patient matters. But a new study published in the Annals of Family Medicine shows that there are several areas in which patient-provider communication can improve during a chronic care diagnosis.

Diabetes is a prevalent chronic illness and the rate of diagnosis is expected to increase substantially worldwide in the next 20 years, the researchers explained.

“Although the impact of diabetes is largely a function of both social determinants of health and genetic predisposition, an important determinant of outcome in primary care settings is the effectiveness of the consultation between patients and health care professionals,” the research team stated.

Patient-provider communication following a diabetes, or other chronic illness, diagnosis needs to strike an important balance of discussing clinical implications and the effect the disease will have on that individual patient’s lifestyle. However, previous patient reports show that providers often miss that mark and that communication can often feel rushed and impersonal, the researchers shared.

The research team identified these barriers in their own analysis, which included videotaped and coded conversations between patients with a new diabetes diagnosis and their diabetes care providers.

READ MORE: How Patient Engagement Supports Chronic Disease Management

Diabetes care is usually managed by a multidisciplinary medical team, and therefore the researchers looked at patient-provider communication for all care team members over a six-month period.

The conversations with 32 patients with new diabetes diagnoses revealed several areas of improvement for patient-provider communication. Providers displayed extensive clinical knowledge about the new patient diagnosis, as well as a moderate understanding of core patient-provider communication principles.

However, providers tended to speak too much about the clinical aspects of the diagnosis and did not put that information into the context of an individual patient’s life circumstances.

The researchers recommended providers assume patients have more of a working knowledge about diabetes from the experiences of family members or friends who have the condition.

This will allow providers to move on from the basic details and begin education about how to integrate management into that specific patient’s life.

READ MORE: Overcoming Patient Barriers to Chronic Disease Management

Patients and providers also communicated as though they were under tremendous time constraints, but conversations generally focused on only a handful of subjects that were not necessary for patients to know at that time, the researchers said.

The providers also displayed limited knowledge of the roles and expertise of other members of the clinical teams, the researchers said. This pitfall is detrimental to the teamwork and care coordination necessary for supporting chronic disease management patients.

Specifically, this lack of care coordination makes certain conversations repetitious, the researchers said. Different specialists should communicate amongst themselves regarding the different topics covered in their respective care encounters, the researchers recommended.

Overall, these findings suggest that providers need to better focus on what the individual patient needs. This will allow providers to target their communication and patient education strategies in a manner that will be more meaningful for patients.

Separate research has indicated that healthcare professionals also need to reshape their patient-provider communications for initial chronic disease diagnosis to ensure patient satisfaction.

READ MORE: Patients Seek More Support with Chronic Disease Management

A new study published in the Journal of Acute and Critical Care Heart and Lung found that patients receiving a pulmonary arterial hypertension (PAH) diagnosis experience depressive symptoms at a higher rate than the general population.

About one-third of patients receiving a PAH diagnosis experience psychological symptoms, likely because they must wait a long period before receiving a final diagnosis. Additionally, patients cited inadequate social support, high perceived stress, and potential quality of life as causes for emotional distress.

While the study did not indicate that any provider shortcomings cause patient anxiety following a PAH diagnosis, it did contend that providers can help mitigate these feelings. Providers must test for depression and other psychological impacts of a chronic disease diagnosis to prevent these symptoms from getting out of control. Additionally, asking a patient about her social supports will allow the provider to set up supplementary support groups for the patient.

Receiving a chronic disease diagnosis can be stressful for any patient. The patient’s current lifestyle is being disrupted as patients now must integrate a new set of medications and care considerations into their daily lives.

Healthcare professionals can help ease the diagnosis burden by employing compassionate patient-provider communication skills that help to comfort the patient. Strategies should likewise put the diagnosis into the context of the patient’s everyday life so the patient is better able to imagine their lives with the new diagnosis.

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