• Leila Keshtkar, Claire D Madigan, Andy Ward, Sarah Ahmed, Vinay Tanna, Ismail Rahman, Jennifer Bostock, Keith Nockels, Wen Wang, Clare L Gillies, and Jeremy Howick.
• Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.).
• Ann. Intern. Med. 2024 Feb 1; 177 (2): 196209196-209.

BackgroundPractitioners who deliver enhanced empathy may improve patient satisfaction with care. Patient satisfaction is associated with positive patient outcomes ranging from medication adherence to survival.PurposeTo evaluate the effect of health care practitioner empathy on patient satisfaction, using a systematic review of randomized trials.Data SourcesOvid MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, and Scopus to 23 October 2023.Study SelectionRandomized trials published in any language that evaluated the effect of empathy on improving patient satisfaction as measured on a validated patient satisfaction scale.Data ExtractionData extraction, risk-of-bias assessments, and strength-of-evidence assessments were done by 2 independent reviewers. Disagreements were resolved through consensus.Data SynthesisFourteen eligible randomized trials (80 practitioners; 1986 patients) were included in the analysis. Five studies had high risk of bias, and 9 had some concerns about bias. The trials were heterogeneous in terms of geographic locations (North America, Europe, Asia, and Africa), settings (hospital and primary care), practitioner types (family and hospital physicians, anesthesiologists, nurses, psychologists, and caregivers), and type of randomization (individual patient or clustered by practitioner). Although all trials suggested a positive change in patient satisfaction, inadequate reporting hindered the ability to draw definitive conclusions about the overall effect size.LimitationsHeterogeneity in the way that empathy was delivered and patient satisfaction was measured and incomplete reporting leading to concerns about the certainty of the underpinning evidence.ConclusionVarious empathy interventions have been studied to improve patient satisfaction. Development, testing, and reporting of high-quality studies within well-defined contexts is needed to optimize empathy interventions that increase patient satisfaction.Primary Funding SourceStoneygate Trust. (PROSPERO: CRD42023412981).

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