Substance use and the quality of patient-provider communication in HIV clinics.
The objective of this study was to estimate the influence of substance use on the quality of patient-provider communication during HIV clinic encounters. Patients were surveyed about unhealthy alcohol and illicit drug use and rated provider communication quality. Audio-recorded encounters were coded for specific communication behaviors. Patients with vs. without unhealthy alcohol use rated the quality of their provider's communication lower; illicit drug user ratings were comparable to non-users. Visit length was shorter, with fewer activating/engaging and psychosocial counseling statements for those with vs. without unhealthy alcohol use. Providers and patients exhibited favorable communication behaviors in encounters with illicit drug users vs. non-users, demonstrating greater evidence of patient-provider engagement. The quality of patient-provider communication was worse for HIV-infected patients with unhealthy alcohol use but similar or better for illicit drug users compared with non-users. Interventions should be developed that encourage providers to actively engage patients with unhealthy alcohol use.
Korthuis
P Todd
PT
Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR 97239-3098, USA. korthuis@ohsu.edu
Saha
Somnath
S
Chander
Geetanjali
G
McCarty
Dennis
D
Moore
Richard D
RD
Cohn
Jonathan A
JA
Sharp
Victoria L
VL
Beach
Mary Catherine
MC
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology; D003142:Communication; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D019966:Substance-Related Disorders / Q000523:psychology