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Original Research: COPD |

Patient-Clinician Communication: Associations With Important Health Outcomes Among Veterans With COPD

Christopher G. Slatore, MD; Laura M. Cecere, MD; Lynn F. Reinke, PhD; Linda Ganzini, MD; Edmunds M. Udris, MPH; Brianna R. Moss, BS; Chris L. Bryson, MD; J. Randall Curtis, MD, FCCP; David H. Au, MD
Author and Funding Information

From Health Services Research and Development (Drs Slatore and Ganzini), Portland Veterans Affairs Medical Center, and the Division of Pulmonary and Critical Care Medicine (Dr Slatore), Oregon Health and Science University, Portland, OR; and Health Services Research and Development (Drs Cecere, Reinke, Bryson, and Au; Mr Udris; and Ms Moss), Veterans Affairs Puget Sound Health Care System, and the Department of Medicine (Drs Cecere, Bryson, Curtis, and Au), University of Washington, Seattle, WA.

Correspondence to: Christopher Slatore, Portland Veterans Affairs Medical Center, 3710 SW US Veterans Hospital Rd, R&D 66, Portland, OR 97239; e-mail: slatore@ohsu.edu


Funding/Support: This work was supported by the Health Services Research and Development, Department of Veterans Affairs [IIR 02-292], and Dr Slatore was supported by funding from the National Institute of Health [CA130328].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(3):628-634. doi:10.1378/chest.09-2328
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Background:  High quality patient-clinician communication is widely advocated, but little is known about which health outcomes are associated with communication for patients with COPD.

Methods:  Using a cross-sectional study of 342 veterans enrolled in a randomized controlled trial, we evaluated the association of communication, measured with the quality of communication (QOC) instrument, with subject-reported quality of clinician care, breathing problem confidence, and general self-rated health. We measured these associations using general estimating equations and adjusted odds ratios (OR) of patient-reported outcomes associated with one-point changes in QOC scores.

Results:  Nearly one-half of the subjects reported receiving the best imaginable care (47%), whereas fewer reported being confident with their breathing problems all the time (29%) or in very good or excellent health (15%). General communication was associated with best-imagined quality of care (OR, 4.29; 95% CI, 2.84-6.48; P < .001) and confidence in dealing with breathing problems all the time (OR, 1.74; 95% CI, 1.34-2.25; P < .001) but not general self-rated health (OR, 1.19; 95% CI, 0.92-1.55; P = .19). Specific clinician behaviors with larger associations with higher quality care included listening, caring, and attentiveness. The associations between general communication and quality care increased over time (P for interaction .03).

Conclusions:  Communication between patients and clinicians is associated with quality of care and confidence in dealing with breathing problems, and this association may change over time. Attention to specific communication strategies may lead to improvements in the care of patients with COPD.


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