Date: 25 Jan 2014
Provider–Patient Communication About Adherence to Anti-retroviral Regimens Differs by Patient Race and Ethnicity
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Disparities in HIV care and outcomes negatively affect Black and Hispanic patients. Features of clinical communication may be a factor. This study is based on coding transcripts of 404 routine outpatient visits by people with HIV at four sites, using a validated system. In models adjusting for site and patient characteristics, with provider as a random effect, providers were more “verbally dominant” with Black patients than with others. There was more discussion about ARV adherence with both Black and Hispanic patients, but no more discussion about strategies to improve adherence. Providers made more directive utterances discussing ARV treatment with Hispanic patients. Possible interpretations of these findings are that providers are less confident in Black and Hispanic patients to be adherent; that they place too much confidence in their White, non-Hispanic patients; or that patients differentially want such discussion. The lack of specific problem solving and high provider directiveness suggests areas for improvement.
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- Provider–Patient Communication About Adherence to Anti-retroviral Regimens Differs by Patient Race and Ethnicity
AIDS and Behavior
Volume 18, Issue 7 , pp 1279-1287
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Health care disparities
- Physician–patient communication
- Medication adherence
- Industry Sectors
- Author Affiliations
- 1. Department of Health Services, Policy and Practice, Brown University, G-S121-7, Providence, RI, 02912, USA
- 2. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- 3. Johns Hopkins University School of Medicine, Baltimore, MD, USA
- 4. Department of Medicine, Department of Public Health & Preventive Medicine, Oregon Health and Science University, Portland, OR, USA
- 5. St. Lukes-Roosevelt, New York, NY, USA
- 6. Wayne State University, Detroit, MI, USA