361 Satisfaction With Provider Communication Is Associated With Perceived Disease Knowledge in Patients With Chronic Kidney Disease (CKD)

Abstract

SATISFACTION WITH PROVIDER COMMUNICATION IS ASSOCIATED WITH PERCEIVED DISEASE KNOWLEDGE IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD) Julie Wright, Kenneth Wallston, Svetlana Eden, Ayumi Shintani, T. Alp Ikizler, Kerri Cavanaugh. Vanderbilt University Medical Center, Nashville, TN USA Effective patient-provider communication is a crucial component of high quality patient care. Data are scarce regarding patient views of physician communication skills in the setting of pre-dialysis CKD care. Adult patients with non-dialysis dependent CKD (Stages 1-5) were enrolled from April-October 2009 during nephrology clinic visits. Patient satisfaction with provider communication was assessed using the Communication Assessment Tool (CAT), a validated scale for measuring patient perception of physician interpersonal and communication skills. Perceived knowledge was assessed by asking patients to rate their CKD knowledge on a scale from 1 (no knowledge) to 4 (a lot of knowledge) in nine areas and averaged to generate an overall perceived knowledge survey (PiKS) score. Associations between CAT and patient characteristics, including PiKS and a validated measure of objective CKD knowledge, were examined. Of 399 patients enrolled, the mean (SD) age was 57 (16) years. 53% were male, 83% Caucasian, and 77% had CKD Stage 3-5. The mean (SD) CAT and PiKS scores were 4.69 (0.51) and 2.56 (0.61), respectively. CAT was associated only with PiKS (Spearman correlation 0.15, p<0.0001) in unadjusted analysis. Patients of older age (OR 1.22 CI [1.11, 1.35]; p<0.0001 per 10 years), higher eGFR (1.03 [1.02, 1.04]; p<0.0001 per 5 ml/min/1.73m), and higher PiKS (2.15 [1.72, 2.68]; p<0.0001 per 1.0 increment increase) were likely to have higher odds of satisfaction with provider communication in adjusted analysis that also included sex, race, health literacy (REALM survey), income, number of provider visits, and objective knowledge. Adjusted analysis presented no evidence that objective knowledge was associated with CAT score. In addition to advancing age and higher eGFR, patients' perception of their disease specific knowledge may be an important component of their satisfaction with CKD care.