Patient-Clinician Communication and Cardiovascular Outcomes: An Analysis of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), 2008-2019
Abstract Body (Do not enter title and authors here):
Background: Strong patient-clinician communication may improve health outcomes for marginalized populations, including Hispanic/Latino individuals.
Objective: We assessed the association between patient-clinician communication and cardiovascular (CV) events or death in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Methods: HCHS/SOL is a longitudinal cohort study of individuals aged 18-74 who identified as Hispanic/Latino at 4 U.S. sites. Participants' ratings of communication with clinicians during the year before enrollment were used to generate a communication score. The primary outcome was the composite of myocardial infarction (MI), heart failure events (HF), stroke, and all-cause mortality. The secondary outcomes included the primary outcome components. The association between the baseline communication score and outcomes of interest was assessed with Cox proportional hazards models adjusting for possible confounders. We also used multivariable linear regression to assess the cross-sectional association between communication and AHA Life’s Essential 8 (LE8), a measure of CV risk factors. All analyses accounted for the complex survey design.
Results: Our sample included 10,527 individuals without prior CV events and at least one medical encounter in the year before enrollment. The median age at enrollment was 41 years (IQR 29, 53), 59% were female, and 71% perceived high-quality communication with clinicians. The mean follow-up time was 9.4 years. High-quality communication was associated with the following results in our adjusted analyses: composite outcome (aHR 0.71, 95% CI 0.49, 1.02, p = 0.066), CV events (aHR 0.79, 95% CI 0.41, 1.51, p = 0.47), all-cause mortality (aHR 0.53, 95% CI 0.35, 0.80, p < 0.01).
Conclusions: High-quality patient-clinician communication was associated with a non-significant trend toward a lower rate of CV events and death, driven by a significant association with lower all-cause mortality.
Slavin, Samuel
( Harvard T.H. Chan School of Public Health
, Boston
, Massachusetts
, United States
)
Mittleman, Murray
( Harvard T.H. Chan School of Public Health
, Boston
, Massachusetts
, United States
)
Daviglus, Martha
( UNIVERSITY ILLINOIS CHICAGO
, Chicago
, Illinois
, United States
)
Garcia-bedoya, Olga
( University of Illinois at Chicago
, Chicago
, Illinois
, United States
)
Mossavar-rahmani, Yasmin
( Albert Einstein College of Medicine
, Bronx
, New York
, United States
)
Perreira, Krista
( University of North Carolina School
, Chapel Hill
, North Carolina
, United States
)
Wassertheil-smoller, Sylvia
( ALBERT EINSTEIN COLL MED
, Bronx
, New York
, United States
)
Ramos, Alberto
( University of Miami
, Miami
, Florida
, United States
)
Sotres-alvarez, Daniela
( University of North Carolina School
, Chapel Hill
, North Carolina
, United States
)
Telzak, Andrew
( Montefiore
, Bronx
, New York
, United States
)
Author Disclosures:
Samuel Slavin:DO NOT have relevant financial relationships
| Murray Mittleman:DO NOT have relevant financial relationships
| Martha Daviglus:DO NOT have relevant financial relationships
| Olga Garcia-Bedoya:DO NOT have relevant financial relationships
| Yasmin Mossavar-Rahmani:DO NOT have relevant financial relationships
| Krista Perreira:No Answer
| Sylvia Wassertheil-Smoller:DO NOT have relevant financial relationships
| Alberto Ramos:No Answer
| Daniela Sotres-Alvarez:No Answer
| Andrew Telzak:DO NOT have relevant financial relationships
Hasabo Elfatih A., Sultan Sherif, Soliman Osama, A. Aboali Amira, Hemmeda Lina, Salah Alaa, Alrawa Salma S., Elgadi Ammar, Abdalmotalib Malaz, Yasir H Eissa Abdullatif, Mahmmoud Fadelallah Eljack Mohammed