TY - JOUR
T1 - Patient-Centered Communication and Outcomes in Heart Failure
AU - Fabbri, Matteo
AU - Finney Rutten, Lila J.
AU - Manemann, Sheila M.
AU - Boyd, Cynthia
AU - Wolff, Jennifer
AU - Chamberlain, Alanna M.
AU - Weston, Susan A.
AU - Yost, Kathleen J.
AU - Griffin, Joan M.
AU - Killian, Jill M.
AU - Roger, Véronique L.
N1 - Funding Information:
Source of Funding: This work was supported by grants from the National Institute on Aging (R01 AG034676); National Heart, Lung, and Blood Institute (R01 HL120859); and the Patient-Centered Outcomes Research Institute (CDRN-1501-26638). The funding sources played no role in the design, methods, subject recruitment, data collection, analysis, or preparation of the paper.
Publisher Copyright:
© 2020 Ascend Media. All rights reserved.
PY - 2020
Y1 - 2020
N2 - OBJECTIVES: To measure the impact of patient-centered communication on mortality and hospitalization among patients with heart failure (HF).STUDY DESIGN: This was a survey study of 6208 residents of 11 counties in southeast Minnesota with incident HF (first-ever International Classification of Diseases, Ninth Revision code 428 or International Classification of Diseases, Tenth Revision code I50) between January 1, 2013, and March 31, 2016.METHODS: Perceived patient-centered communication was assessed with the health care subscale of the Chronic Illness Resources Survey and measured as a composite score on three 5-point scales. We divided our cohort into tertiles and defined them as having fair/poor (score<12), good (score of 12 or 13), and excellent (score≥14) patient-centered communication. The survey was returned by 2868 participants (response rate: 45%), and those with complete data were retained for analysis (N=2398). Cox and Andersen-Gill models were used to determine the association of patient-centered communication with death and hospitalization, respectively.RESULTS: Among 2398 participants (median age, 75 years; 54% men), 233 deaths and 1194 hospitalizations occurred after a mean (SD) follow-up of 1.3 (0.6) years. Compared with patients with fair/poor patient-centered communication, those with good (HR, 0.70; 95% CI, 0.51-0.97) and excellent (HR, 0.70; 95% CI, 0.51-0.96) patient-centered communication experienced lower risks of death after adjustment for various confounders (Ptrend=.020). Patient-centered communication was not associated with hospitalization.CONCLUSIONS: Among community patients living with HF, excellent and good patient-centered communication is associated with a reduced risk of death. Patient-centered communication can be easily assessed, and consideration should be given toward implementation in clinical practice.
AB - OBJECTIVES: To measure the impact of patient-centered communication on mortality and hospitalization among patients with heart failure (HF).STUDY DESIGN: This was a survey study of 6208 residents of 11 counties in southeast Minnesota with incident HF (first-ever International Classification of Diseases, Ninth Revision code 428 or International Classification of Diseases, Tenth Revision code I50) between January 1, 2013, and March 31, 2016.METHODS: Perceived patient-centered communication was assessed with the health care subscale of the Chronic Illness Resources Survey and measured as a composite score on three 5-point scales. We divided our cohort into tertiles and defined them as having fair/poor (score<12), good (score of 12 or 13), and excellent (score≥14) patient-centered communication. The survey was returned by 2868 participants (response rate: 45%), and those with complete data were retained for analysis (N=2398). Cox and Andersen-Gill models were used to determine the association of patient-centered communication with death and hospitalization, respectively.RESULTS: Among 2398 participants (median age, 75 years; 54% men), 233 deaths and 1194 hospitalizations occurred after a mean (SD) follow-up of 1.3 (0.6) years. Compared with patients with fair/poor patient-centered communication, those with good (HR, 0.70; 95% CI, 0.51-0.97) and excellent (HR, 0.70; 95% CI, 0.51-0.96) patient-centered communication experienced lower risks of death after adjustment for various confounders (Ptrend=.020). Patient-centered communication was not associated with hospitalization.CONCLUSIONS: Among community patients living with HF, excellent and good patient-centered communication is associated with a reduced risk of death. Patient-centered communication can be easily assessed, and consideration should be given toward implementation in clinical practice.
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U2 - 10.37765/ajmc.2020.88500
DO - 10.37765/ajmc.2020.88500
M3 - Article
C2 - 33094937
AN - SCOPUS:85094684266
SN - 1088-0224
VL - 26
SP - 425
EP - 430
JO - American Journal of Managed Care
JF - American Journal of Managed Care
IS - 10
ER -