Communication about depression during rheumatoid arthritis patient visits.
OBJECTIVE
To examine whether rheumatologists and rheumatoid arthritis (RA) patients with depressive symptoms communicate about depression.


METHODS
The data used in this study came from a randomized controlled trial to improve provider-patient communication about patients' agendas. The current secondary analysis used data collected at baseline, before any intervention occurred. A total of 200 RA patients from 4 rheumatology clinics participated in the study. Patient medical visits were audiotape recorded and patients were interviewed after their medical visits. Physicians recorded patients' American College of Rheumatology (ACR) functional status after their visits.


RESULTS
Twenty-one (11%) patients were scored as having moderately severe to severe symptoms of depression. Patients who were rated by their physicians as having worse ACR functional status were more than twice as likely to have moderately severe to severe symptoms of depression (odds ratio 2.23, 95% confidence interval 1.1-4.6). Only 4 (19%) of the 21 patients who were scored as having moderately severe to severe symptoms of depression discussed depression during their medical visits, and patients initiated the discussion each time.


CONCLUSIONS
Rheumatologists should consider assessing depressive symptoms among their patients, especially among those with worse functional status.
Sleath
Betsy
B
University of North Carolina, Sheps Center for Health Services Research, Chapel Hill, NC 27599-7630, USA. betsy_sleath@unc.edu
Chewning
Betty
B
de Vellis
Brenda M
BM
Weinberger
Morris
M
de Vellis
Robert F
RF
Tudor
Gail
G
Beard
Ashley
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D003144:Communication Barriers; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012219:Rheumatology; D012720:Severity of Illness Index; D013637:Tape Recording