Journal of general internal medicine · 2026
Does Patient-Centered Communication by Physicians Facilitate Cardiometabolic Disease Self-management Among Community Health Center Patients? A Nationwide Study.
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Xirasagar Sudha, Nan Zixiao, Platonova Elena, Merrell Melinda, Natafgi Nabil
Аннотация
BACKGROUND: Cardiometabolic self-management through lifestyle behavior change is critical for patients with cardiometabolic risk conditions (obesity, high blood pressure, type 2 diabetes (T2DM) and/or dyslipidemia) to avoid life-threatening complications.
OBJECTIVE: To examine whether patient-centered communication (PCC) by community health center (CHC) physicians may facilitate patients with cardiometabolic conditions to implement disease self-management behaviors in daily life.
RESEARCH DESIGN: We used secondary data from the 2022 Health Services and Resources Administration-Research Triangle International-designed, nationally representative sample survey of CHC patients (response rate 85.0%). We assessed the association of patients' adoption of cardiometabolic self-management behaviors in five domains (weight management, dietary change, physical activity, reducing sedentariness, and smoking reduction) with ratings of their physician's PCC during primary care visits.
PARTICIPANTS: 2,942 adults aged 18-74 years, with cardiometabolic condition(s) completing a primary care visit.
MEASURES: Outcome: Cardiometabolic self-management (SM) score, sum of patient's weighted fraction scores of behaviors in five domains, multiplied by 100 to obtain a whole integer-based, ratio-scale score. Key independent variable: Patient-rated physician PCC aggregated from scores on five adapted Consumer Assessment of Healthcare Providers and Systems survey questions (CAHPS) during primary care visits (Likert scale 0-3).
RESULTS: Among 2,942 study-eligible patients (25.3% with T2DM, 62.8% obesity, 60.1% hypertension, 50.9% dyslipidemia), the mean cardiometabolic SM score was 246.3 (±82, median 250, possible score range, -30 to 470). The mean PCC score (validated by exploratory factor analysis) was 17.7 (±3.3, median 20, possible range 0-20). A unit increase in PCC was associated with 1.8-point increase in patients' SM score (SE 0.5, p<0.001), after adjusting for demographic variables, chronic conditions, and patient-reported measures of their enabling environment for physical activity, food security, and physical/mental health disability.
CONCLUSIONS: Physicians' PCC as measured by the CAHPS survey may promote better self-management of cardiometabolic conditions by CHC patients who often have low health literacy.
OBJECTIVE: To examine whether patient-centered communication (PCC) by community health center (CHC) physicians may facilitate patients with cardiometabolic conditions to implement disease self-management behaviors in daily life.
RESEARCH DESIGN: We used secondary data from the 2022 Health Services and Resources Administration-Research Triangle International-designed, nationally representative sample survey of CHC patients (response rate 85.0%). We assessed the association of patients' adoption of cardiometabolic self-management behaviors in five domains (weight management, dietary change, physical activity, reducing sedentariness, and smoking reduction) with ratings of their physician's PCC during primary care visits.
PARTICIPANTS: 2,942 adults aged 18-74 years, with cardiometabolic condition(s) completing a primary care visit.
MEASURES: Outcome: Cardiometabolic self-management (SM) score, sum of patient's weighted fraction scores of behaviors in five domains, multiplied by 100 to obtain a whole integer-based, ratio-scale score. Key independent variable: Patient-rated physician PCC aggregated from scores on five adapted Consumer Assessment of Healthcare Providers and Systems survey questions (CAHPS) during primary care visits (Likert scale 0-3).
RESULTS: Among 2,942 study-eligible patients (25.3% with T2DM, 62.8% obesity, 60.1% hypertension, 50.9% dyslipidemia), the mean cardiometabolic SM score was 246.3 (±82, median 250, possible score range, -30 to 470). The mean PCC score (validated by exploratory factor analysis) was 17.7 (±3.3, median 20, possible range 0-20). A unit increase in PCC was associated with 1.8-point increase in patients' SM score (SE 0.5, p<0.001), after adjusting for demographic variables, chronic conditions, and patient-reported measures of their enabling environment for physical activity, food security, and physical/mental health disability.
CONCLUSIONS: Physicians' PCC as measured by the CAHPS survey may promote better self-management of cardiometabolic conditions by CHC patients who often have low health literacy.