Patient-physician communication of health and risk information in the management of cardiovascular diseases and diabetes: a systematic scoping and narrative review

Abstract

Background The communication of health and risk information is an integral and essential part of patient-physician interaction. Effective communication of risk information in the context of chronic diseases such as cardiovascular diseases and diabetes has been shown to improve medication adherence, increase physical activity levels, and improve dietary control. Patients who are able to understand their risk profile and risk factors, are better able to self-manage and work towards modifying their lifestyle behaviours as part of a continuing shared decision-making process with physicians. This scoping review examines the evidence on patient-physician risk communication strategies, approaches and interventions for CVDs and diabetes management in the primary care and secondary outpatient settings. Methods A comprehensive database search for quantitative and qualitative studies was conducted in PubMed, Embase, Web of Science, Scopus, CINAHL, PsycINFO, and Cochrane Library from 1st Jan 2000 to 3rd October 2023. Two reviewers independently performed the screening of articles, studies that specifically report on patient-physician risk communication processes were included. Relevant data were extracted and analysed using descriptive summaries and narrative synthesis. Results are reported in accordance with PRISMA-ScR guidelines. Included articles were appraised for quality following JBI critical appraisal and MMAT tools. Results A total of 8378 articles published between Jan 2000 to 3rd October 2023 were screened. After full text review of 88 articles, a total of 30 articles, consisting of 15 qualitative, 14 quantitative and 1 mixed method studies were included. Common areas of inquiry among included articles on patient-physician risk communication include: (1) understanding and recalling risk information, (2) strategies and approaches used by physicians to communicate risk, and (3) interventions to improve the communication of risk. Studies reveal how physicians use a range of strategies, approaches and interventions to discuss risk with patients with CVD and diabetes. Based on the included articles, we present and discuss each theme narratively in detail. Conclusion There is a critical need for further research into risk communication strategies for cardiovascular diseases (CVDs) and diabetes. Research should focus on developing targeted approaches that enhance patients' understanding of their risk profiles. Additionally, it should provide evidence-based guidelines to assist physicians and healthcare professionals in improving risk communication within clinical settings. The goal is to facilitate patient comprehension of their health risks and support sustained lifestyle and behavioural changes through informed, evidence-based methods. Misalignment in communication may lead to confusion, dissatisfaction, and lack of clarity, which may impede the effective management of chronic conditions.