Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity

M. Barton Laws; Yoojin Lee; William H. Rogers; Mary Catherine Beach; Somnath Saha; P. Todd Korthuis; Victoria Sharp; Jonathan Cohn; Richard Moore; Ira B. Wilson

doi:10.1007/s10461-014-0697-z

Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity

M. Barton Laws, Yoojin Lee, William H. Rogers, Mary Catherine Beach, Somnath Saha, P. Todd Korthuis, Victoria Sharp, Jonathan Cohn, Richard Moore, Ira B. Wilson

Internal Medicine

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1279-1287
Number of pages	9
Journal	AIDS and Behavior
Volume	18
Issue number	7
DOIs	https://doi.org/10.1007/s10461-014-0697-z
State	Published - Jul 2014

Keywords

HIV
Health care disparities
Medication adherence
Physician-patient communication

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity. / Laws, M. Barton; Lee, Yoojin; Rogers, William H.; Beach, Mary Catherine; Saha, Somnath ; Korthuis, P. Todd; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Wilson, Ira B.

In: AIDS and Behavior, Vol. 18, No. 7, 07.2014, p. 1279-1287.

Research output: Contribution to journal › Article › peer-review

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abstract = "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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author = "Laws, {M. Barton} and Yoojin Lee and Rogers, {William H.} and Beach, {Mary Catherine} and Somnath Saha and Korthuis, {P. Todd} and Victoria Sharp and Jonathan Cohn and Richard Moore and Wilson, {Ira B.}",

note = "Funding Information: Acknowledgments This research was supported by award numbers R34MH089279 and R01MH083595 from the National Institute of Mental Health; and by a contract from the Health Resources Service Administration and the Agency for Healthcare Research and Quality (AHRQ 290-01-0012). Dr. Wilson was supported by the National Institute of Mental Health (2 K24MH092242). Dr. Korthuis{\textquoteright} time was supported by the National Institutes of Health, National Institute on Drug Abuse (K23DA019809). Dr. Saha was supported by the Department of Veterans Affairs. The views expressed here are those of the authors, and no official endorsement by the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the Department of Veterans Affairs is intended or should be inferred.",

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