Alyce S. Adams|Melissa M. Parker|Howard H. Moffet|Marc G. Jaffe|Dean Schillinger|Brian C. Callaghan|John D. Piette|Nancy E. Adler|Amy M. Bauer|Andrew J. Karter
Communication Barriers and the Clinical Recognition of Diabetic Peripheral Neuropathy in a Diverse Cohort of Adults: The DISTANCE Study
Kaiser Permanente|Kaiser Permanente|Kaiser Permanente|Kaiser Permanente South San Francisco Medical Center|San Francisco General Hospital|University of California, San Francisco|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of San Francisco|University of Washington|Kaiser Permanente
purpose study explore communication barriers independent predictors potential mediators variation clinical recognition diabetic peripheral neuropathy dpn crosssectional analysis estimated likelihood dpn diagnosis among 4436 patients dpn symptoms controlled symptom frequency demographic clinical characteristics visit frequency using modified poisson regression model evaluated 4 communication barriers independent predictors clinical documentation possible mediators racialethnic differences difficulty speaking english talking ones doctor pain limited health literacy reports suboptimal patientprovider communication difficulty speaking english talking ones doctor pain independently associated diagnosis though limited health literacy suboptimal patientprovider communication limited english proficiency partially attenuated fully explain racialethnic differences clinical documentation among chinese latino filipino patients providers encouraged talk patients dpn symptoms health systems consider enhancing strategies improve timely clinical recognition dpn among patients difficult speaking english work needed understand persistent racialethnic differences diagnosis