Abstract Body: Introduction: Cardiometabolic conditions, such as diabetes, dyslipidemia, and hypertension are prevalent among Hispanic/Latino adults in the U.S. Interpersonal processes of care (IPC) are the social-psychological aspects of patient-clinician interaction that are important to improve delivery of care. Our study aimed to explore the potential association between IPC and treatment of cardiometabolic outcomes among Hispanic/Latino adults between 2020-2024.
Methods: Sample of 6,608 participants from the HCHS/SOL cohort with a primary care visit from the previous year. The IPC is a 14-item patient-reported measure of 3 domains: 1) communication, 2) decision-making, and 3) interpersonal style. All items were assessed on a scale of 1 (never) to 5 (always) with higher scores indicating positive experiences. Cardiometabolic outcomes were assessed using HCHS/SOL defined threshold measurements for diabetes (≥ 6.5 % A1C or ≥ 126 mg/dL fasting plasma glucose or diabetes medication), dyslipidemia (LDL cholesterol ≥160mg/dL, HDL cholesterol ≤40 mg/dL, or triglycerides ≥200 mg/dL), and hypertension (≥140 mmHg systolic or ≥90 mmHg diastolic). Outcome was determined as either treated or untreated based on the self-reported medication use. Weighted survey analysis methods were used to account for the complex sampling within the HCHS/SOL study. Multivariable logistic regression models were used to estimate the associations between IPC domains and treatment of cardiometabolic outcomes.
Results: Overall, participants reported usually or always having positive experiences with their physicians across communication (mean score= 4.4, standard error [SE]=0.01), patient centered decision-making (mean score= 3.9, SE = 0.02), and interpersonal process of care (mean score= 4.64, SE= 0.01). Across each IPC domain higher scores were associated with higher odds of treated diabetes (odds ratio [OR]= 1.40, 95% confidence interval [CL]= 1.11, 1.78 and OR= 1.23, 95% CL= 1.08, 1.41 and OR= 1.49, 95% CL= 1.10, 2.01). Higher communication and patient-centered decision-making scores were significantly associated with higher odds of treated hypertension (OR=1.25, 95% CL= 1.04,1.49 and OR= 1.11, 95% CL= 1.01,1.23), but only higher patient-centered decision-making scores were significantly associated with treated dyslipidemia (OR= 1.17, 95% CL= 1.07,1.28).
Conclusion: Patients who report more positive IPC experiences are more likely to have their diabetes, hypertension and dyslipidemia treated.