title: Examining the association between patient-centered communication and provider avoidance, CAM use, and CAM-use disclosure.
abstract: BACKGROUND
  Patients' perceptions of the quality of their relationships with health care providers may influence their health care-seeking behaviors and future interactions with providers, including use of conventional health care, use of complementary and alternative medicine (CAM), and disclosure of CAM use.
  
  
  OBJECTIVE
  The study examined the associations between perceived patient-centered communication and provider avoidance, CAM use, and CAM-use disclosure.
  
  
  METHODS
  This study used cross-sectional survey data from the Health Information National Trends Survey (HINTS) 3, a nationally representative survey of US adults collected between January 2008 and May 2008.
  
  
  METHODS
  Two questions asked about CAM use and CAM-use disclosure, and another asked about avoidance of doctors. For the independent variable, responses from 6 questions on patient-centered communication were averaged to create a scale score ranging from 1-4. The research team conducted multiple logistic regressions of the 3 primary outcome measures, adjusting for sociodemographic characteristics, presence or absence of a regular source of care, insurance status, frequency of visits to providers, and health status. All analyses were weighted to make the results representative of the US population aged ≥18 y.
  
  
  RESULTS
  Approximately one-third of respondents (36%) had avoided seeing their doctors within the 12 mo prior to the survey. Approximately 24% had used CAM within the prior 12 mo, and 51.7% of CAM users had discussed their CAM use with their doctors. Higher levels of patient-centered communication were significantly associated with lower odds of provider avoidance (AOR=0.63; 95% CI=0.52, 0.76) and CAM use (AOR=0.60; 95% CI=0.46, 0.78) but were not associated with CAM-use disclosure.
  
  
  CONCLUSIONS
  Findings suggest that patients may be more likely to avoid seeing their doctors and more likely to use CAM when they perceive low levels of patient-centered communication. Further research to understand the role of the characteristics of patient-provider relationships on provider avoidance, CAM use, and CAM-use disclosure is warranted.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Faith
authors.forename: Sheryl
authors.initials: S
authors.lastname: Thorburn
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Tippens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D055815:Young Adult