The Patient-Physician Relationship and Adherence: Observations From a Clinical Study

August 2023 | Volume 22 | Issue 8 | 838 | Copyright © August 2023


Published online July 31, 2023

Patrick O. Perche BSa, Rohan Singh BSa, Madison K. Cook BSa, Katherine A. Kelly BSa, Esther A. Balogh MDa, Irma Richardson MHAa, Steven R. Feldman MD PhDa,b,c

aCenter for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC
bDepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 
cDepartment of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC




was assessed using a univariate linear regression model. Data was analyzed using the SAS Software 9.4. 

RESULTS

Subjects were mean age 62 years (median 50 years), 93% Caucasian, and 70% female. Mean adherence for all subjects over three months of study was 62% (median 66%). Mean PDRQ-9 score for all subjects was 38.5 (median 40). Subjects who perceived a weaker PPR (less than or equal to 6, n=10) were less adherent over 3 months, with an average adherence rate of 45%, compared with subjects who perceived a stronger PPR (greater than or equal to 37, n=17), with an average adherence rate of 70% (P=0.03). PDRQ-9 scores positively correlated with adherence rates for 3 months of treatment (r(26)=0.52; P=0.006). Adherence did not vary by age or gender (P=0.59 and 0.51, respectively; Table 2).

DISCUSSION

Subjects with a stronger perceived PPR had greater adherence over three months of treatment. The perceived strength of the PPR may have a role in patients' adherence to their medications. Improving the PPR, through empathy and effective communication, may facilitate better medication adherence and treatment outcomes.5

DISCLOSURES

Dr. Feldman has received research, speaking, and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Baxter, Boeringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Taro, Abbvie, Cosmederm, Anacor, Astellas, Janssen, Lilly, Merck, Merz, Novartis, Regeneron, Sanofi, Novan, Parion, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation.  He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients' adherence to treatment. Patrick Perche, Rohan Singh, Madison Cook, Katherine Kelly, Esther Balogh, and Irma Richardson have no conflicts of interest to report.

Funding sources: Galderma

REFERENCES

  1. Ahn CS, Culp L, Huang WW, et al. Adherence in dermatology. J Dermatolog Treat. 2017;28(2):94-103. doi:10.1080/09546634.2016.1181256
  2. McCabe R, Healey PGT. Miscommunication in doctor-patient communication. Top Cogn Sci. 2018;10(2):409-424. doi:10.1111/tops.12337
  3. Van der Feltz-Cornelis CM, Van Oppen P, Van Marwijk HW, et al. A patientdoctor relationship questionnaire (PDRQ-9) in primary care: development and psychometric evaluation. Gen Hosp Psychiatry. 2004;26(2):115-20. doi:10.1016/j.genhosppsych.2003.08.010
  4. El Alili M, Vrijens B, Demonceau J, Evers SM, et al. A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence. Br J Clin Pharmacol. 2016;82(1):268-79. doi:10.1111/bcp.12942
  5. Gómez G, Aillach E. Ways to improve the patient-physician relationship. Curr Opin Psychiatry. 2013;26(5):453-7. doi:10.1097/YCO.0b013e328363be50

AUTHOR CORRESPONDENCE

Patrick O. Perche BS patrickperche@ufl.edu
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