Chest
Volume 132, Issue 5, Supplement, November 2007, Pages 802S-809S
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The Contributing Role of Health-Care Communication to Health Disparities for Minority Patients With Asthma

https://doi.org/10.1378/chest.07-1909Get rights and content

Asthma is a common, chronic illness with substantial morbidity, especially for racial and ethnic minorities in the United States. The care of the patient with asthma is complex and depends ideally on excellent communication between patients and health-care providers. Communication is essential for the patient to communicate the severity of his or her illness, as well as for the health-care provider to instruct patients on pharmacologic and nonpharmacologic care. This article describes evidence for poor provider/patient communication as a contributor to health-care disparities for minority patients with asthma. Communication problems stem from issues with patients, health-care providers, and health-care systems. It is likely that asthma disparities can be improved, in part, by improving patient/provider communication. While much is known presently about the problem of patient/provider communication in asthma, there is a need to improve and extend the evidence base on the role of effective communication of asthma care and the links to outcomes for minorities. Additional studies are needed that document the extent to which problems with doctor/patient communication lead to inadequate care and poor outcomes for minorities with asthma, as well as mechanisms by which these disparities occur.

Section snippets

Prevalence of Asthma Disparities

Asthma, a chronic disease characterized by airway inflammation, was active in 20 million people in the United States in 2002.1 It accounts annually for 1.9 million emergency department (ED) visits, 12.7 million office visits, and an economic burden of $5.1 billion.1, 2 The burden of asthma in the United States, however, is not uniform. Compared to whites, the prevalence of asthma is particularly high in Puerto Ricans, non-Hispanic blacks, and American Indians. Asthma morbidity is strikingly

Poor Provider/Patient Communication May Be More Common for Minority Patients

National guidelines for asthma care contained in the 1997 National Heart, Lung, and Blood Institute-sponsored expert panel report22 highlight the importance of active partnership between patients and physicians. This partnership is highly relevant for effective communication about asthma symptoms, medications, and appropriate self-management (eg, education to avoid triggers and intensify medication regimens during exacerbations). However, a number of studies23, 24, 25, 26 have reported that

Reducing Asthma Disparities by Improving Patient/Provider Communication

The quality of communication between patients and their health-care providers has been shown to be related to satisfaction with care and adherence with therapy.67, 68, 69, 7071, 72, 73, 74 Improved physician/patient communication is likely to increase patient involvement and adherence to recommended therapy, as well as improve quality of care and health outcomes.75 For example, a study76 that was designed to enhance provider/patient communication showed a resulting increase in patient

Gaps and Opportunities for Research

Generally, there is much empiric evidence of problems related to doctor/patient communication and how these problems may lead to poorer care and outcomes. While some studies have been conducted with patients who have asthma, much of the evidence is derived from patients with other conditions. Areas where research is needed are numerous and include the following:

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    Studies are needed that document the extent to which problems with doctor/patient communication lead to inadequate care and poor

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    The author has no conflict of interest to disclose.

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