Rushed Communication Between HCPs and Black Patients Leads to Worse Glycemic Control

The following article is part of coverage from the American Diabetes Association’s 80th Scientific Sessions (ADA 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all ADA 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the ADA 2020 virtual experience.

Hurried communication with healthcare providers can have significant negative effects on glycemic control in black patients with type 2 diabetes (T2D), according to study results presented during the American Diabetes Association’s 80th Scientific Sessions, held online from June 12 to 16, 2020.

The disparities in T2D outcomes experienced by black patients are not fully explained by patient- and system-level factors. In a cross-sectional study, researchers analyzed aspects of the patient-provider relationship and their associations with race and glycemic outcomes in patients with T2D. A total of 106 non-Hispanic black and 115 non-Hispanic white patients completed the study (mean age, 64.4 years; 55% women; mean hemoglobin A1c [HbA1c], 7.3%).

The Interpersonal Processes of Care survey was used to measure patient-provider relationships with regard aspects such as hurried communication, eliciting concerns and response, explanation of results and treatments, patient-centered decision making, compassion and respect, discrimination, and disrespect from office staff. In linear regression models, these subscales were not associated with any main effects in the overall cohort.

However, for non-Hispanic black patients, provider communication and explanation had significant interactions with glycemic outcomes. Among black patients who reported no hurried communication, HbA1c was on average 0.45% lower (95% CI, -1 to 0.1) compared with those who reported some hurried communication (P =.48), and for black patients who reported full explanation of results and medications, HbA1c was on average 0.64% lower (95% CI, -1.19 to -0.08) compared with those who did not endorse a full explanation of results and medications from their providers (P =.01).

Based on these findings, and considering the same associations were not observed among white patients, the study authors concluded that interventions aimed at improving communication and explanation in the patient-provider relationship “may reduce racial disparities in glycemic control.”

Reference

Reid H, Lin O, Fabbro RL, et al. Provider communication in black patients with T2DM is associated with glycemic control. Presented at: American Diabetes Association 80th Scientific Sessions; June 12-16, 2020. Abstract 52-LB.

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