Quality of doctor-patient communication in cardiovascular diseases and secondary preventive adherence: the role of gender

Abstract

Background: The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. What are the associations between the quality of communication and the improvement of secondary preventive behaviours? How does gender influence these relationships? Methods: 1,289 patients who underwent a coronary angiography in 2008/09 in Luxembourg completed a self-administered questionnaire at the time of the visit, and at a five-year follow-up. The probability of improving each preventive eating behaviour (decrease of salt, sugar, fat consumption and increase of fruits/vegetables), and the quality of doctor-patient communication (5-item scale) were evaluated using logistic regression models. Sex was introduced in interaction with the communication score. Findings: Among hypertensive respondents, a higher quality of communication was associated with a higher probability of decreasing the salt intake in women (OR [95% CI]: 1.139 [1.060; 1.223]) whereas in men, the OR was only 1.086 [1.017; 1.159]. ORs were also higher in women among patients with hypertension, overweight and hypercholesterolemia regarding the increase of fruits/vegetables consumption; among patients with diabetes and hypercholesterolemia regarding sugar decrease or cessation; and among patients with overweight and hypercholesterolemia regarding fat reduction or stop. ORs were slightly higher among men only among diabetic and obese patients, regarding the increase of fruits/vegetables consumption. Discussion: The quality of the communication showed an effect on the adoption of secondary preventive eating behaviours, especially in women patients. Motivational interviews could encourage, especially men patients, to adhere to the recommendations about lifestyle change.