| Effect of patient-centered communication training on discussion and detection of nonadherence in glaucoma. | |
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MedLine Citation:
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PMID: 20207417 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To assess communication about adherence and to determine the impact of communication skills training on physicians' approach to nonadherence. DESIGN: Sociolinguistic analysis of videotaped community ophthalmologists' encounters with patients with glaucoma before and after training. Patients in both phases and physicians in phase I knew communication was being studied but not what the focus of the study was. In phase II, physicians knew the targeted communication behaviors. PARTICIPANTS: Twenty-three ophthalmologists and 100 regularly scheduled patients with glaucoma (50 per phase). METHODS: An educational program with videotaped vignettes of simulated patient encounters using audience response and role play to teach patient-centered communication skills, including a 4-step adherence assessment and the use of open-ended questions in ask-tell-ask sequences. MAIN OUTCOME MEASURES: Physician eliciting an acknowledgment of nonadherence during a clinical encounter compared with acknowledgment of nonadherence during a postvisit research interview (primary outcome), and performance of targeted communication and substantive discussion of adherence. RESULTS: After intervention, physicians increased the proportion of open-ended questions (15% vs 6%; P = 0.001) and specifically about medication taking (82% compared with 18% of encounters; P<0.001). Compared with the absence of ask-tell-ask communication, 32% of phase II encounters included a complete ask-tell-ask sequence, 78% included an ask-tell sequence, and 32% a tell-ask sequence (P<0.001). Three of 4 steps for assessment of adherence were more common in phase II, and substantial discussions of adherence occurred in 86% versus 30% of encounters (P<0.001). In phase II, physicians elicited acknowledgment of nonadherence in 78% (7/9) of those who acknowledged nonadherence in the postvisit interview compared with 25% in phase I (3/12; P = 0.03). CONCLUSIONS: This study demonstrates that experienced community physicians significantly improved their communication strategies and ability to detect and address nonadherence after a 3-hour educational program. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references. |
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Authors:
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Steven R Hahn; David S Friedman; Harry A Quigley; Sameer Kotak; Elizabeth Kim; Meaghan Onofrey; Corey Eagan; Jack Mardekian |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-03-07 |
Journal Detail:
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Title: Ophthalmology Volume: 117 ISSN: 1549-4713 ISO Abbreviation: Ophthalmology Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-07-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802443 Medline TA: Ophthalmology Country: United States |
Other Details:
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Languages: eng Pagination: 1339-47.e6 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Clinical Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York 10461, USA. steveroost@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Communication Education, Medical, Continuing* Female Glaucoma / drug therapy* Humans Male Middle Aged Ophthalmology / education* Patient Compliance / psychology* Patient Education as Topic Patient-Centered Care / methods* Physician-Patient Relations* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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