Quality Of Patient-provider Communication Research Articles

Impact of telehealth on patient-provider communication in prenatal care for pregnant women from underserved settings

ABSTRACT Introduction: Telehealth has emerged as a promising supplementary modality in prenatal care. However, its impact on patient-provider communication (PPC), especially among pregnant women from underserved settings, requires comprehensive evaluation. This study examined the factors associated with the quality of patient-provider communication during the COVID-19 pandemic among pregnant telehealth users and non-users. Methods: Using a cross-sectional study design, 242 women were surveyed (response rate = 23%) regarding their experience with telehealth, quality of PPC, and experiences of discrimination during prenatal care. Multiple regression models were used to identify the factors associated with the quality of PPC during the COVID-19 pandemic. A sub-group analysis explored the factors associated with the quality of PPC separately among telehealth users and non-users. Results: The majority of the participants were on Medicaid (95%) and self-identified as Black/African American (57.3%). Regression analyses revealed a negative relationship between telehealth use during pregnancy and the quality of PPC (β = −1.13, P = 0.002). Irrespective of the telehealth use, the experience of discrimination was associated with poor quality of PPC among users (β = −3.47, P = .02) and non-users (β = −.78, P = .03), while adjusting for sociodemographic factors and social support during pregnancy. Discussion: While telehealth offers advantages like convenience, increased accessibility, and continuity of care, challenges in establishing effective PPC in virtual settings have emerged that emphasize the necessity for comprehensive provider training extending beyond technical competencies. The persistent issue of perceived discrimination, impacting PPC across both groups, underscores the necessity to rethink existing strategies of mandatory training to increase providers’ knowledge.

Patient trust, quality communication, and medication adherence in rheumatoid arthritis patients highly affected by social determinants of health.

Because medication adherence is essential to the management of rheumatoid arthritis (RA), identifying (1) subgroups at high risk for low medication adherence and (2) modifiable factors potentially contributing to low adherence can impact patient outcomes. This study aims to describe the relationships between anxiety, trust in the provider, quality patient-provider communication, fatigue, RA knowledge, adverse medication effects, disease activity, RA medications, disease duration, patient satisfaction, and medication intolerance and cluster factors to differentiate RA-patient subgroups. This observational study used correlation analysis, linear regression, and cluster analysis with determination decisions based on Schwarz's Bayesian Criterion. Medication adherence was higher in non-Hispanic, White participants, inversely correlated with disease activity and pain intensity, and positively correlated with trust in the provider. Patient satisfaction was higher among those with a shorter time since diagnosis, and was negatively associated with disease activity, pain intensity and interference, fatigue, and anxiety. It was positively associated with RA knowledge, trust in provider and quality of patient-provider communication. Medication intolerance differed by disease duration and was positively correlated with disease activity, pain interference, and fatigue. Of the two clusters, Cluster 1 participants had greater medication adherence and patient satisfaction, and lower medication intolerance. They were of higher income, employed, and non-Hispanic, White persons with a shorter disease duration and lower perceived pain intensity/interference, fatigue, and anxiety. They were more knowledgeable about RA with higher trust in their provider and perceived quality of patient-provider communication. A low medication adherence RA-patient subgroup-highly affected by social determinants of health and with unique relational and clinical characteristics was identified.

Patient-provider communication quality: Socioeconomic disparities in smoking outcomes.

Patient-provider communication quality is instrumental for healthy outcomes in patients. The objective of this study is to examine the relationships between patient-provider communication quality and participant characteristics, perception of e-cigarette harmfulness, and smoking outcomes. A pooled cross-sectional design was used on secondary data obtained from the Health Information National Trends Survey (HINTS) 5 from Cycle 1 through Cycle 4, from 2017-2022. Our final sample contained 3511 observations. Our outcome variable was the perception of electronic cigarette smoking status. The independent variable was patient-provider communication quality (PPCQ), measured from a series of questions with responses on a 4-item Likert scale (always, usually, sometimes, never). Demographic variables such as marital status, health insurance status, occupation status, and health-related variables were used as participant characteristics. Ordinal logistic regression models were used to examine the above relationships. Compared to males, females had lower odds of being in a higher category of perception of e-cigarette harmfulness compared to other categories of e-cigarette harmfulness (AOR=0.66; 95% CI: 0.57-0.76). Respondents who were non-Hispanic Black or Hispanic had lower odds of being in a higher category of perception of e-cigarettes compared to Whites (AOR=0.52; 95% CI: 0.49-0.78, and AOR=0.51; 95% CI: 0.41-0.65, respectively). Respondents who had higher education level compared to those with less than high school had lower odds (AOR=0.30; 95% CI: 0.17-0.51), and Hispanics compared to Whites had higher odds (AOR=1.59; 95% CI: 1.05-2.40), of being former smokers rather than current smokers. Providers should invest in staff training and development to target the populations that need conversations regarding e-cigarette usage.

Association between patient-provider communication and withholding information due to privacy concerns among women in the United States: an analysis of the 2011 to 2018 Health Information National Trends Survey

BackgroundElectronic medical record software is common in healthcare settings. However, data privacy and security challenges persist and may impede patients’ willingness to disclose health information to their clinicians. Positive patient-provider communication may foster patient trust and subsequently reduce information nondisclosure. This study sought to characterize information-withholding behaviors among women and evaluate the association between positive patient-provider communication and women’s health information-withholding behavior in the United States.MethodsData were pooled from the 2011 to 2018 Health Information National Trends Survey. We used descriptive statistics, bivariate, and logistic regression analyses to investigate whether positive patient-provider communication significantly impacted health information-withholding behaviors. Data from 7,738 women were analyzed.ResultsAbout 10.8% or 1 in 10 women endorsed withholding health information from their providers because of privacy or security concerns about their medical records. After adjusting for the covariates, higher positive patient-provider communication scores were associated with lower odds of withholding information from the provider because of privacy and security concerns (aOR 0.93; 95% CI = 0.90–0.95). Additionally, we found that age, race/ethnicity, educational status, psychological distress, and smoking status significantly predicted women’s willingness to disclose health information.ConclusionsFindings suggest that improving positive patient-provider communication quality may reduce women’s privacy and security concerns and encourage them to disclose sensitive medical information.

Racial disparities in cancer genetic counseling encounters: study protocol for investigating patient-genetic counselor communication in the naturalistic clinical setting using a convergent mixed methods design

BackgroundDespite decades of effort to reduce racial cancer disparities, Black people continue to die at higher rates from cancer than any other U.S. racial group. Because prevention is a key to the cost-effective and long-term control of cancer, the potential for cancer genetic counseling to play a central role in reducing racial cancer disparities is high. However, the benefits of genetic counseling are not equitable across race. Only 2% of genetic counselors self-identify as Black/African American, so most genetic counseling encounters with Black patients are racially discordant. Patients in racially discordant medical interactions tend to have poorer quality patient-provider communication and receive suboptimal clinical recommendations. One major factor that contributes to these healthcare disparities is racial bias. Drawing on findings from prior research, we hypothesize that genetic counselor providers’ implicit racial prejudice will be associated negatively with the quality of patient-provider communication, while providers’ explicit negative racial stereotypes will be associated negatively with the comprehensiveness of clinical discussions of cancer risk and genetic testing for Black (vs. White) patients.MethodsUsing a convergent mixed methods research design, we will collect data from at least 15 genetic counseling providers, from two different institutions, and their 220 patients (approximately equal number of Black and White patients per provider) whose appointments are for a hereditary cancer condition. The data sources will include two provider surveys, two patient surveys, video- and/or audio-recordings of genetic counseling encounters, and medical chart reviews. The recorded cancer genetic counseling in-person and telehealth encounters will be analyzed both qualitatively and quantitatively to assess the quality of patient-provider communication and the comprehensiveness of clinical discussion. Those data will be linked to pre- and post-encounter survey data and data from medical chart reviews to test our hypotheses.DiscussionFindings from this multi-site study will highlight specific aspects of cancer genetic counseling encounters (patient-provider communication and clinical recommendations) that are directly associated with patient-centered outcomes (e.g., satisfaction, trust, genetic testing completion). Patient-provider communication and clinical recommendations are modifiable factors that can be integrated into current genetic counseling training curricula and thus can have immediate impact on genetic counseling training and practice.

Colorectal cancer screening disparities in Asian Americans: the influences of patient-provider communication and social media use.

We examined the role of patient-provider communication (PPC) during in-person visits and via electronic communication and social media use on colorectal cancer (CRC) screening among Asian Americans (AAs) and Non-Hispanic Whites (NHWs) aged 50 and older. Health Information National Trends Survey 2017-2020 data were analyzed. AAs tended to evaluate the quality of PPC during their in-person visits to a health care provider lower than NHWs. AAs' CRC screening rate was lower than the rate of NHWs (78.8% vs. 84.4%). After adjusting for sociodemographics, healthcare access, and health status, the quality of PPC was the only significant predictor associated with a lower probability of CRC screening among AAs (Adjusted OR 0.74; 95% CI 0.56, 0.96); while the Internet to communicate with a health care provider was the only significant predictor of CRC screening among NHWs (Adjusted OR 1.76; CI 1.11, 2.79). AAs were more likely to use YouTube to watch a health-related video than NHWs (43.5% vs, 24%). However, social media use was not associated with CRC screening in both AAs and NHWs. Use of electronic communication technology may contribute to improve health information literacy and reduce the disparity. On-line communication may empower the culturally and linguistically diverse AAs by improving their confidence in communication with health care providers. Thus, communication technologies need to be strategically utilized and tailored to better meet the communication needs of racial/ethnic minorities. Online communication technologies may reduce the disparities in PPC related to cancer screening and cancer burden experienced by AAs.

Communication matters when it comes to adverse events: Associations of adverse events during implant treatment with patients’ communication quality and trust assessments

ObjectivesBecause patients' trust in their physicians is a critical factor in improving health outcomes and patient response to adverse events, it is important to analyze the determinants of trust. One of these determinants is patient-centered communication. Because the occurrence of adverse events must be communicated to the patient, we asked whether the perceived quality of patient-physician communication acts as an isolating factor between adverse events and patient trust. MethodsWe proposed and tested a structural equation model linking the occurrence of adverse events to the mediator patient-provider communication quality and to the outcome patient trust. The model was controlled for sociodemographic and health-related factors. We used online survey data from German implant patients (n = 1312), as implant treatment is associated with frequent adverse events such as infections. ResultsOur results show that adverse events during implant treatment are associated with small but significantly lower trust levels. Patient-provider communication quality partially mediates this association. ConclusionsPatient trust does not appear to be immune to deterioration from adverse events. Patient-provider communication plays a role in mitigating this association. Practice ImplicationsTo improve the quality of care, attention should be paid to how adverse events are communicated in a patient-centered manner.

Patient-provider communication quality as a predictor of medical mistrust among young Black women

ABSTRACT The present study explores the association between patient-provider communication quality and medical mistrust in a sample of 174 young Black women, aged 18–24. Data were collected as part of a larger mixed-methods study examining sexual health communication and behaviors. Participants were recruited via non-probabilistic sampling methods between June 2018 and December 2018. Eligible respondents completed a self-administered online study that examined, among other components, healthcare experiences and medical mistrust. Hierarchical linear regression was used to explore the relationship between patient-provider communication quality and medical mistrust. Patient-provider communication quality was a significant predictor of medical mistrust; as communication quality increased, medical mistrust decreased (p < .001). Educational attainment also emerged as a significant predictor. Relative to not completing any college, completing some college was associated with lower medical mistrust (p= .031). Our findings suggest that for providers seeking to address medical mistrust in patients identifying as young Black women, focusing on patient-centered communication may be particularly impactful.

Self-efficacy to Get Cancer-Related Information or Advice.

Self-efficacy, or confidence, for being able to get cancer information may affect a person's understanding of cancer risk and subsequent cancer-related decisions such as screening, treatment, and genetic testing. In this study, we explored key correlates associated with self-efficacy for getting cancer information. We analyzed cross-sectional data from the 2018 Health Information National Trends Survey (HINTS 5, Cycle 2). There were 3504 responses in the full dataset; 2513 remained after eliminating respondents with incomplete data for all variables of interest. Self-efficacy for getting cancer information was assessed with the item, "Overall, how confident are you that you could get advice or information about cancer if you needed it?" First, we explored correlates associated with self-efficacy in getting cancer information including sociodemographic factors, patient-provider communication, and health-related self-efficacy in the full sample. Secondarily, we examined associations between self-efficacy to get cancer information and cancer information-seeking burden (e.g., difficulty understanding cancer information) in the subset of participants who reported ever looking for cancer-specific information. Descriptive statistics and logistic regressions were conducted. Asian race/ethnicity, higher perceived quality of patient-provider communication, and higher health-related self-efficacy were associated with higher odds of confidence about getting cancer information. In the subset of people who ever sought cancer-specific information, higher patient-provider communication scores, higher health-related self-efficacy, greater difficulty understanding information, greater concern about the quality of information, and greater frustration during the search were associated with higher self-efficacy for getting cancer information. Future research should evaluate strategies to improve cancer information seeking skills.

Patient Experience with Their Health Care Provider Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus by Race and Ethnicity in the United States.

The study objective was to investigate differences in patient experiences with health care providers among non-pregnant women of childbearing age with diabetes mellitus (DM) by race/ethnicity. This study used cross-sectional data from the 2012-2018 Medical Expenditure Panel Survey. The sample was limited to women of childbearing age (18-45 years) who have ever been told they had diabetes (n = 763; weighted n = 903,670). The key independent variable was race/ethnicity. The variables of interest included patient experiences with health care in the past 12 months: patient-provider communication (PPC); patient-provider racial/ethnic concordance; patient-provider gender concordance; and satisfaction. After adjusting for age, marital status, education, poverty level, health insurance, and perceived health status, non-Hispanic (NH) Black women had lower odds (adjusted odds ratio [aOR] = 0.04; 95% confidence interval [CI] = 0.01-0.11) of receiving care from a health care provider of the same race compared with NH white women. Similar results were found among Hispanic and NH women of other or multiple races. Hispanic women had lower odds (aOR = 0.18; 95% CI = 0.06-0.50) of seeing a health care provider of the same race/ethnicity compared with NH white women in adjusted models. There were no statistically significant differences in PPC, patient-provider gender concordance, and satisfaction with their health care provider among Hispanic, NH Black, or NH women of other or multiple races in comparison to NH White women. There is a need to improve PPC quality and satisfaction in this patient population. Patient-provider racial/ethnic discordance among women of color with DM is concerning given the existing diabetes-related disparities. More research on women with DM is needed to inform and improve patient experience and health outcomes.

Sociodemographic factors and perceived patient-provider communication associated with healthcare avoidance among women with psychological distress.

To establish the extent to which psychological distress influences health avoidance behavior among women, controlling for patient provider communication and sociodemographic characteristics. Data from the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3) was analyzed to obtain healthcare avoidance behavior among women aged 18 and older (n = 2788). Weighted descriptive, bivariate, and multivariable logistic regression models were conducted. Approximately 649 women or 1 in 4 women (26.7% weighted prevalence; 95% Confidence Interval [CI] 0.23%-0.29%) avoided healthcare in the past 12 months. Non-Hispanic white (62.8%) and married (55.4%) women represented a higher proportion of the sample. Bivariate analysis revealed that the odds of reporting healthcare avoidance among women with mild, moderate, and severe psychological distress (Odds Ratio [OR]: 2.26, 95% CI: 1.45-3.53, p = 0.001; OR: 3.88, 95% CI: 2.29-6.56, p < 0.001; OR: 3.08, 95% CI: 1.81-5.23, p < 0.001) was significantly higher compared to those with none-minimal psychological distress. In the adjusted model, women with moderate and severe psychological distress (Adjusted OR [AOR]:3.15, 95% CI: 1.55-6.38, p = 0.002; AOR: 2.24, 95% CI: 1.10-4.92, p = 0.044) were more likely to report healthcare avoidance than those experiencing none-minimal psychological distress. Furthermore, increasing patient-provider communication score (AOR: 0.91, 95% CI: 0.87-0.96, p < 0.001) reduced the likelihood of healthcare avoidance. Among the sociodemographic variables assessed, being younger (18-49 years) and having less than a high school degree significantly increased the chances of avoiding healthcare. A high proportion of women with psychological distress avoid necessary healthcare. Patient-provider communication quality, increasing age, and being a high school student contribute to healthcare avoidance in women. Strategies to improve health service utilization must address healthcare avoidance by developing effective health communication targeted at women with psychological distress.

Telemedicine Experience for PrEP Care among PrEP-Eligible Women and Their Primary Care Providers during the First Year of the COVID-19 Pandemic in the United States

(1) Background: During the two-year-long siege from the COVID-19 pandemic, a significant proportion of doctor visits transitioned from in-person to virtual. Scare evidence is available to assess the quality of patient-provider communication via the platform of telemedicine, especially for PrEP care within primary care settings. (2) Methods: Participants included 18 primary care providers and 29 PrEP-eligible women. Through content analysis and thematic analysis, facilitators and barriers embedded at different levels of telemedicine were identified and assessed. (3) Results: Women and providers reported pros and cons regarding their telemedicine experiences during the initial wave of COVID-19. Both groups of participants agreed that telemedicine visits were more convenient, efficient, and comfortable than in-person visits. However, without face-to-face interactions, some women felt less empathy, caring, and connected with their providers during virtual visits. Health providers expressed concerns with telemedicine, including patients’ privacy, lack of intimacy between patients and providers, and delayed lab work. (4) Conclusions: Our data indicate multi-level factors may affect telemedicine experience among PrEP-eligible women and health providers. Participants expressed concerns that may further entrench these long-existing health disparities in healthcare. Proactive efforts from policymakers, health professionals, researchers, and stakeholders are urgently required to tackle identified barriers and to pave the way for the new infrastructure that ensures health equity in society.

"Death is as Much Part of Life as Living": Attitudes and Experiences Preparing for Death from Older Adults with Sickle Cell Disease.

The life-limiting and unpredictable nature of sickle cell disease (SCD) is well-established, yet there is limited literature on end-of-life planning. The purpose of this study was to describe perspectives about preparing for death for older adults with SCD. We enrolled 19 older adults with SCD (age ≥ 50years) into this qualitative descriptive study. Theme 1 was "anticipation of early death," with sub-themes: (a) informed of early death and (b) making plans for death. Theme 2 was "near death experiences." Theme 3 was "differences in level of comfort with death" with subthemes: (a) death as a part of life and (b) differences in level of comfort discussing death. Theme 4 was "influence of spirituality" with subthemes: (a) God controls the timing of death and (b) belief in the afterlife. These results will inform interventions to improve the quality of patient-provider communication to provide goal-concordant end-of-life care for adults with SCD.

Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions.

Screening is an essential prevention practice for a number of health conditions. However, screening coverage remains generally low. Studies that investigate determinants of screening participation are becoming more common, but oftentimes investigate screening for health conditions in an individualized rather than integrated fashion. In routine clinical practice, however, healthcare professionals are often confronted with situations in which several screening procedures are recommended for the same patient. The consideration of their common determinants may support a more integrated screening approach. The objectives of this umbrella review were therefore to examine: 1) the determinants (barriers and facilitators) that have been identified in relation to recommended health screening procedures; and 2) the modifiable determinants (in primary care) common across health conditions or specific to individual procedures. Results were presented through a narrative synthesis. PubMed, PsycInfo and Cochrane weresearched up to January 2022. Systematic reviews reporting determinants of participation in health screening procedures with grade A or B recommendation according to the US Preventive Services Task Forcewere included. A total of 85 systematic reviews were included, most which contained both qualitative and quantitative studies on determinants that describe individual factors (961 occurrences), social factors (113 occurrences, healthcare professional factors (149 occurrences), health system factors (105 occurrences) and screening procedure factors (99 occurrences). The most studied screening procedures concerned cervical cancer/human papillomavirus (n = 33), breast cancer (n = 28), colorectal cancer (n = 25) and the human immunodeficiency virus (n = 12). Other conditions have been under-studied (e.g. cardiovascular problems, lung cancer, syphilis). The individual domain, including determinants such as knowledge, beliefs and emotions, was the most covered across health conditions. Healthcare professional's recommendations and the quality of patient-provider communication were identified to have a strong influence on screening participation in most conditions. The other three domains included determinants which were more specific to a condition or a population. Various determinants modifiable in primary care were found in the individual domain and in the health system, healthcare professional and screening procedure domains. Quality was assessed as low for most systematic reviews included. The identification of various modifiable determinants common across conditions highlights the potential of an integrated screening participation approach. Interventions may address common determinants in a broader person-centred framework within which tailoring to specific procedures or populations can be considered. This approach needs to be explored in intervention studies. The systematic review registration is PROSPERO CRD42019126709.

Patient-Provider Communication Quality, 2002-2016: A Population-based Study of Trends and Racial Differences.

Effective patient-provider communication (PPC) can improve clinical outcomes and therapeutic alliance. While PPC may have improved over time due to the implementation of various policies for patient-centered care, its nationwide trend remains unclear. The objective of this study was to examine trends in PPC quality among US adults and whether trends vary with race-ethnicity. A repeated cross-sectional study. We examine noninstitutionalized civilian adults who made 1 or more health care visits in the last 12 months and self-completed the mail-back questionnaire in the Medical Expenditure Panel Survey, 2002-2016. Outcomes include 4 top-box measures, each representing the odds of patients reporting that their providers always (vs. never, sometimes, usually) used a given communication behavior in the past 12 months regarding listening carefully, explaining things understandably, showing respect, and spending enough time. A linear mean composite score (the average of ordinal responses for the behaviors above) is also examined as an outcome. Exposures include time period and race-ethnicity. Among 124,158 adults (181,864 observations), the quality of PPC increases monotonically between 2002 and 2016 for all outcomes. Between the first and last periods, the odds of high-quality PPC increase by 37% [95% confidence interval (CI)=32%-43%] for listen, 25% (95% CI=20%-30%) for explain, 41% (95% CI=35%-47%) for respect, and 37% (95% CI=31%-43%) for time. The composite score increases by 3.24 (95% CI=2.87-3.60) points. While increasing trends are found among all racial groups, differences exist at each period. Asians report the lowest quality throughout the study period for all outcomes, while Blacks report the highest quality. Although racial differences narrow over time, most changes are not significant. Our findings suggest that providers are increasingly likely to use patient-centered communication strategies. While racial differences have narrowed, Asians report the lowest quality throughout the study period, warranting future research.

Dental EHR-infused Persona Ontologies to Enrich Dental Dialogue Interaction of Agents.

The quality of patient-provider communication can predict the healthcare outcomes in patients, and therefore, training dental providers to handle the communication effort with patients is crucial. In our previous work, we developed an ontology model that can standardize and represent patient-provider communication, which can later be integrated in conversational agents as tools for dental communication training. In this study, we embark on enriching our previous model with an ontology of patient personas to portray and express types of dental patient archetypes. The Ontology of Patient Personas that we developed was rooted in terminologies from an OBO Foundry ontology and dental electronic health record data elements. We discuss how this ontology aims to enhance the aforementioned dialogue ontology and future direction in executing our model in software agents to train dental students.

Correlates of the perceived quality of patient-provider communication among German adults.

Since a higher perceived quality of patient-provider communication is known to be associated with improved health outcomes, it is essential to analyze determinants influencing patients' perceived quality of patient-provider communication. Due to the limited knowledge about patient-related influencing factors of quality perception available so far, the objective of this study is to explore and assess determinants of the perceived quality of patient-provider communication with regards to sociodemographic, health-related, healthcare-specific and information-related factors. Linear regression of cross-sectional data from the first wave of Health Information National Trends Survey Germany (n = 2902) was conducted. Independent variables were sociodemographic, health-, healthcare- and information-related factors; the dependent variable was the perceived quality of patient-provider communication. Results show that age, migration background, the perceived quality of healthcare, health-related self-efficacy and trust in health information from health professionals are significantly associated with the perceived quality of patient-provider communication. Sociodemographic, healthcare- and health information-related factors influence the perceived quality of patient-provider communication. In particular, patients having a migration background and patients reporting low self-efficacy showed significant lower levels of their perceived patient-provider communication quality. With the aim to improve quality issues, patients of both target groups should be empowered and supported.

Symptom Burden, Palliative Care Needs, and Patient-Provider Communication Among Chronic Myeloid Leukemia Survivors

Background: Chronic myeloid leukemia (CML) patients are living longer, yet can be challenged by disease complications, adverse effects of treatment, and lifelong drug therapy. CML symptoms and treatment side effects (SEs) are often chronic, and patients may need care from a multidisciplinary team of specialists. The study objectives were to examine CML patients' symptom burden, palliative care needs, and experiences with health care team (HCT) communication.Methods: 310 people diagnosed with CML enrolled in the Cancer Support Community's Cancer Experience Registry and completed questions about CML history, treatment, and symptoms. Participants rated the extent to which 19 symptoms and SEs interfered with daily life (0= not at all ; 4= very much); ratings were summed into a symptom burden score (α=.89). Participants also rated 10 items assessing quality of patient-provider communication about SEs (0 = strongly disagree; 4 = strongly agree); items were summed into a SEs communication quality total score (α=.83). Bivariate associations between communication quality and sociodemographic, symptom history, and symptom burden variables were examined; significant variables were included in multiple linear regression analysis predicting SEs communication quality.Results: Participants were 68% female, 89% White; mean age was 56 years (SD=12); mean time since diagnosis was 5 years (SD=6). 65% reported hematologic remission, 42% cytogenic remission, 64% molecular remission; <1% had not yet had a response to CML treatment; 3% had an initial response but were no longer responding. 88% indicated more than one health care provider manages their CML; of those, 72% were satisfied with care coordination. Respondents reported the following symptoms interfered (somewhat to very much) with daily life: fatigue (70%), muscle aches (57%), sleep disturbance (46%), loss of concentration/memory (42%), sexual or intimate relation problems (38%), bone pain (37%), rash or skin issues (35%), anxiety (34%), diarrhea (32%), sadness/depression (32%), nausea (31%), water retention around the eyes (31%), appetite change (29%), constipation (27%), hand/foot swelling (22%), infection (15%), sores not healing (12%), heart problems (7%), and excess lung fluid (7%). 52% believed their HCT prepared them to manage treatment SEs. 67% felt confident in their ability to cope or get help with treatment SEs. 41% reported that potential SEs at least somewhat affected treatment choice. 51% wished they had received more help with managing short-term SEs, and 59% with managing long-term SEs. 81% reported being satisfied with HCT communication about CML treatment, yet only 65% were satisfied with communication about treatment SEs, and 40% did not report the full extent of their symptoms/SEs to their HCT. 74% indicated it was “somewhat” to “very easy” to contact their HCT with questions or concerns, and 76% believed their HCT takes enough time to address concerns. Regression analysis indicated that three predictors explained 51% of the variance in SEs communication quality (R2 = .51, F (3,268) = 93.68, p <.001). Poorer SEs communication quality was associated with less confidence in coping with SEs (semipartial r=.33, p <.001), more holding back from telling the HCT about SEs (semipartial r=−.34, p <.001), and wanting more help managing long-term SEs and symptoms (semipartial r=−.21, p <.001). Greater symptom burden was associated with poorer SEs communication quality in bivariate analysis (r=−.41, p <.001) but the relationship was only a trend in the multivariate model (semipartial r=−.07, p=.10).Conclusion: People with CML experience significant symptom burden and want more support with managing symptoms and side effects. Importantly, those reporting less satisfaction with health care team communication about side effects tended to report greater symptom burden, less confidence in coping with side effects, and greater desire for support in managing symptoms. The results from this study indicate the need for more comprehensive symptom management as part of CML survivorship care, including increased attention to symptom burden during health care team conversations and access to palliative and other supportive care services. DisclosuresMauro:Bristol-Myers Squibb: Consultancy. Buzaglo:Pharmacyclics, Inc: Research Funding; Pfizer Oncology: Research Funding; Novartis: Research Funding; Janssen Biotech, Inc: Research Funding; Genentech, Inc: Research Funding; Eli Lilly and Company: Research Funding; Celgene Corporation: Research Funding; Bristol-Myers Squibb: Research Funding; Boehringer Ingelheim: Research Funding; Bayer: Research Funding; Amgen Corporation: Research Funding; AbbVie: Research Funding; Takeda Oncology: Research Funding.

Adopting Telehealth During The COVID-19 Era: The Urologist's Perspective

ObjectiveTo evaluate the urology providers’ (through a range of training levels) experience utilizing telemedicine given the rapid nationwide implementation of telemedicine in urology practices due to COVID-19. Several studies focusing on the patient's perspective have illustrated that telemedicine is comparable to traditional office visits in terms of cost, communication, and overall satisfaction. However, there is sparse data on the provider's experience. MethodsWith IRB approval, we assessed provider satisfaction with telemedicine at Urology programs in the U.S. through an electronic survey. The 25-question survey was based on the Patient Assessment of Communication of Telehealth which is a validated 33 question instrument that has been utilized to assess the quality of patient-provider communication in telemedicine. Experience with telemedicine was assessed in 2 categories: technical aspects and communication with patients. Variables were rated using a 5-point Likert Scale. ResultsThere were 144 responses to the survey. 50% of providers reported not receiving any formal training in using telemedicine. This differed significantly by training level with 55% of attendings having had received training vs 20% of residents. Providers felt they would most benefit from training in billing (52%) rather than equipment use (33%) or communication (28%). 87% of providers felt comfortable discussing sensitive topics while only 55% felt comfortable using telehealth to schedule surgery (P < .001). ConclusionUrology providers are generally satisfied with their experience communicating with patients via telemedicine and the majority would opt to continue utilizing telemedicine. Nevertheless, many providers are hesitant to schedule surgery via telemedicine. Providers would benefit from formal training in telemedicine.

Assessing the relationship between patient-provider communication quality and quality of life among rural cancer survivors.

We explored relationships between patient-provider communication quality (PPCQ) and three quality of life (QOL) domains among self-identified rural cancer survivors: social well-being, functional well-being, and physical well-being. We hypothesized that high PPCQ would be associated with greater social and functional well-being, but be less associated with physical well-being, due to different theoretical mechanisms. All data were derived from the 2017-2018 Illinois Rural Cancer Assessment (IRCA). To measure PPCQ and QOL domains, we respectively used a dichotomous measure from the Medical Expenditure Panel Survey's Experience Cancer care tool (high, low/medium) and continuous measures from the Functional Assessment of Cancer Therapy-General (FACT-G). Our sample of 139 participants was largely female, non-Hispanic White, married, and economically advantaged. After adjusting for demographic and clinical variables, patients who reported high PPCQ exhibited greater social well-being (Std. β = 0.20, 95% CI: 0.03, 0.35, p = 0.02) and functional well-being (Std. β = 0.20, 95% CI: 0.05, 0.35, p = 0.03) than patients with low/medium PPCQ. No association was observed between PPCQ and physical well-being (Std. β = 0.06, 95% CI: - 2.51, 0.21, p = 0.41). Sensitivity analyses found similar, albeit attenuated, patterns. Our findings aligned with our hypotheses. Future researchers should explore potential mechanisms underlying these differential associations. Specifically, PPCQ may be associated with social and functional well-being through interpersonal mechanisms, but may not be as associated with physical well-being due to multiple contextual factor rural survivors disproportionately face (e.g., limited healthcare access, economic hardship) and stronger associations with clinical factors.