• Mary Lynn Davis-Ajami, Zhiqiang K Lu, and Jun Wu.
• School of Nursing and Health Sciences, Merrimack College, North Andover, MA, USA.
• J Gen Intern Med. 2023 May 1; 38 (6): 145914671459-1467.

BackgroundMultiple chronic conditions (MCC) require complex patient-centered approaches with effective provider-patient communication.ObjectiveTo describe trends in patient perceptions of provider-patient communication during non-emergency care and identify associated racial disparities in US older adults with MCC.Design, Setting, ParticipantsObservational study using pooled US Medical Expenditure Panel Survey (2013-2019) data included adults > 65 with two or more chronic conditions.Main MeasuresProvider-patient communication was measured by four indicators (how often their doctor explained things clearly, listened carefully, showed respect, and spent enough time with them). The primary outcomes were the annual rates of reporting "always" for the communication indicators. Cochran-Armitage trend tests examined the trends of reporting "always" and associated racial disparities. Multivariable logistic regression identified racial and other factors associated with respondents choosing "always" for one or more categories for provider-patient communication, defined as positive communication.ResultsAmong 9758 older adults with MCC, declining trends for positive communication were shown across all provider-patient communication categories during 2013 to 2019 (p<0.001). The greatest decrease occurred in "always listening carefully", from 68.6% in 2013 to 59.1% in 2019 (p<0.001). The declining trends of four communication measures in non-Hispanic Whites with MCC were significant (p<0.001). Older adults from Hispanic or Non-Hispanic Black racial backgrounds were 28 to 51% more likely to report "always" for the four indicators of provider-patient communication than non-Hispanic Whites after adjusting for respondents' characteristics.ConclusionThe rates of "always" reporting positive communication with providers significantly declined from 2013 to 2019 in older adults with MCC, particularly in non-Hispanic Whites. Hispanics and non-Hispanic Blacks were more likely to report positive communication with providers than other races.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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