Abstract
BackgroundImproving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question. We aimed to examine the effectiveness of communication skills training for physicians on the hypertension outcomes and the health literacy skills, self-efficacy and medication adherence in patients with uncontrolled blood pressure (BP).MethodsA randomized, controlled trial method was conducted on 240 hypertensive patients and 35 physicians presenting to healthcare clinics in the Mashhad, Iran, from 2013 to 2014. Using stratified blocking with block sizes of 4 and 6, eligible patients with uncontrolled blood pressure were randomly allocated to the intervention and control groups. Physicians in the intervention group received educational training over 3 sessions of Focus –Group Discussion and 2 workshops. The control group received the routine care. The primary outcome was a reduction in systolic and diastolic BP from baseline to 6 months. The secondary outcome was promoting HL skills in hypertensive patients. Data were analyzed using the regression model and bivariate tests.ResultsAfter the physician communication training, there was a significant improvement in physicians-patient communication skills, hypertension outcomes, medication adherence, and self-efficacy among the patients being managed by the physicians receiving training, compared to the control group.ConclusionThe educational intervention leads to better BP control; it may have been sufficient training of physicians change to impact counseling, HL and self-efficacy and adherence. The quality of physician-patient communication is an important modifiable element of medical communication that may influences health outcomes in hypertensive Iranian patients.Trial registrationIranian Registry of Clinical Trials (IRCT), IRCT20160710028863N24. Registered April 4, 2018 [retrospectively registered].
Highlights
Improving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question
The results of the physician-patient communication skills showed that 66.7% of the patients needed more support from the physician and they had difficulty in written and spoken communication
Our findings showed that physician communication training may directly impact hypertensive outcomes (DBP and SBP), and more often it had an indirect effect on hypertensive outcomes through its influence on intervening variables
Summary
Improving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question. We aimed to examine the effectiveness of communication skills training for physicians on the hypertension outcomes and the health literacy skills, self-efficacy and medication adherence in patients with uncontrolled blood pressure (BP). There is growing evidence that developing patient experience is a potential way to improve the clinical health outcomes and quality of life for patients with a chronic condition; in part, this may be due to increasing patient cooperation in the treatment process [7, 8]. Several studies showed that effective physicianpatient communication has a strong incentive to improve medical outcomes, patient HL, safety patient adherence and psychosocial support [9, 11]
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