Neda Ratanawongsa|Andrew J. Karter|Melissa M. Parker|Courtney R. Lyles|Michele Heisler|Howard H. Moffet|Nancy E. Adler|E. Margaret Warton|Dean Schillinger
Communication and Medication Refill Adherence
poor medication refill adherence contributes poor cardiometabolic control diabetes outcomes studies linking communication patients health care providers adherence often use selfreported adherence explored differences across communication domains therapeutic indicationsto investigate associations patient communication ratings cardiometabolic medication refill adherence conducted crosssectional analysis 9377 patients diabetes study northern california distance racestratified random sample kaiser permanente survey respondents eligible participants received 1 oral hypoglycemic lipidlowering antihypertensive medication 12 months preceding survey communication measured 4item consumer assessment healthcare providers systems survey cahps score 4 items trust physicians interpersonal processes care instruments poor adherence classified greater 20 continuous medication gap ongoing medication therapies using modified least squares regression calculated differences poor adherence prevalence 10point decrease cahps score compared higher vs lower communication ratings items adjusting necessary sociodemographic medical confounders derived directed acyclic graphin cohort 30 poor cardiometabolic medication refill adherence 10point decrease cahps score adjusted prevalence poor adherence increased 09 p01 compared patients offering higher ratings patients gave health care providers lower ratings involving patients decisions understanding patients problems treatment eliciting confidence trust likely poor adherence absolute differences 4 p04 5 p02 6 p03 respectively associations communication adherence somewhat larger hypoglycemic medications medicationspoor communication ratings independently associated objectively measured inadequate cardiometabolic medication refill adherence particularly oral hypoglycemic medications future studies investigate whether improving communication skills among clinicians poorer patient communication ratings could improve patients cardiometabolic medication refill adherence outcomes