Not Just Words

Epstein, Andrew S.

doi:10.1001/jamainternmed.2013.365

Cited by 4 publications

(1 citation statement)

References 6 publications

(5 reference statements)

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“…It may also stimulate improved patient-centered communication by simply “using the right words” (Epstein, 2013). It may have the greatest utility among non-White dialysis subjects who are known to have an increased prevalence and severity of bone mineral disorder (Gutierrez et al, 2008; Kalantar-Zadeh et al, 2010), less adherence to medications than Whites even after adjusting for significant confounders (Charles et al, 2003; Gerber et al, 2010; Shenolikar et al, 2006), and less perceived autonomy support.…”

Section: Discussionmentioning

confidence: 99%

Health care providers’ support of patients’ autonomy, phosphate medication adherence, race and gender in end stage renal disease

Umeukeje¹,

Merighi²,

Browne³

et al. 2016

J Behav Med

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This study was designed to assess dialysis subjects’ perceived autonomy support association with phosphate binder medication adherence, race and gender. A multi-site cross-sectional study was conducted among 377 dialysis subjects. The Health Care Climate (HCC) Questionnaire assessed subjects’ perception of their providers’ autonomy support for phosphate binder use, and adherence was assessed by the self-reported Morisky Medication Adherence Scale (MMAS). Serum phosphorus was obtained from the medical record. Regression models were used to examine independent factors of medication adherence, serum phosphorus, and differences by race and gender. Non-white HCC scores were consistently lower compared with white subjects’ scores. No differences were observed by gender. Reported phosphate binder adherence was associated with HCC score, and also with phosphorus control. No significant association was found between HCC score and serum phosphorus. Autonomy support, especially in non-white end stage renal disease subjects, may be an appropriate target for culturally informed strategies to optimize mineral bone health.

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