title: Substance use and the quality of patient-provider communication in HIV clinics.
abstract: 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.
authors: Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR 97239-3098, USA. korthuis@ohsu.edu
authors: P Todd
authors: PT
authors: Korthuis
authors: Somnath
authors: S
authors: Saha
authors: Geetanjali
authors: G
authors: Chander
authors: Dennis
authors: D
authors: McCarty
authors: Richard D
authors: RD
authors: Moore
authors: Jonathan A
authors: JA
authors: Cohn
authors: Victoria L
authors: VL
authors: Sharp
authors: Mary Catherine
authors: MC
authors: Beach
mesh_terms: 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