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Researchers at Johns Hopkins
University in Baltimore investigated whether the quality of patients’
relationships with their HIV care providers helped patients keep routine care
appointments. They were looking for potential targets for future interventions
to improve providers’ interactions with patients, promote retention in care,
and help patients have better outcomes in HIV care. The researchers studied
1,363 of their clinic patients between 2004 and 2009. Participants were mostly
male (65 percent), non-white (85 percent), and with a mean age of 46 years.
Two-thirds were on antiretroviral therapy and 49 percent had undetectable viral
load.
Each participant completed a
computer-assisted questionnaire rating the quality of communication and
relationship with their care providers in the following five areas: being
treated with dignity and respect; being involved in decisions about care;
feeling listened to; having information explained in a way that could be
understood; and feeling known as a person. Researchers hypothesized that high
ratings for doctors and healthcare providers would be associated with higher
attendance levels at routine clinic appointments.
Participants rated their healthcare
providers highly in all five areas, with 85–94 percent of patients giving the
highest possible ratings. Results indicated that patients who believed that
their healthcare providers really knew them as a person kept 6 percent more
appointments than those who did not share that level of belief. Participants
who gave highest ratings in terms of being treated with dignity and respect and
always having information explained in a way that was understandable, and
careful listening were 7, 7, and 6 percent more likely to keep their
appointments, respectively, than those who gave lower ratings in these areas.
High rating for involvement in decision making was not associated with higher
levels of attendance at appointments.
The results surprised researchers.
When they included all communication and relationship variables into a single
model, which they adjusted for demographic factors and substance use, “feeling
known as a person” was the only factor associated with significantly higher
rates of clinic attendance. Researchers concluded that the study suggests that
healthcare providers could enhance appointment adherence by improving the
quality of relationships, so that patients feel known and respected as persons
by them. Also, provider communication behaviors such as listening and carefully
explaining could make a difference in retaining patients in care.
The full report, “Higher Quality
Communication and Relationships are Associated with Improved Patient Engagement
in HIV Care,” was published online in the Journal of Acquired Immune Deficiency
Syndromes (2013; doi: 10.1097/QAI.0b013e318295b86a).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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