An unequal burden: Poor patient-provider communication and sickle cell disease

Objective: To assess disparities in the quality of healthcare provider communication experienced by African-American adults with and without sickle cell disease (SCD) in the U.S. Methods: Poor provider communication was assessed by the Provider Communication subscale of the Consumer Assessment of Healthcare Plans and Systems survey. The SCD sample was obtained from participants in a multicenter observational study of healthcare experiences. The national African-American sample data was obtained from published national estimates. Results: The SCD sample was more likely than the national sample to report poor communication in 3 out of 4 communication domains: listening (22.3% vs. 11.5%, p<. 0.0001); showing respect (26.1% vs. 9.5%, p<. 0.0001); and spending enough time (38.3% vs. 16.2%, p<. 0.0001). Differences were consistent in young, but not old, patients and showed some variation by self-reported health status and education. Conclusions: The communication difficulties experienced by persons with SCD do not appear reducible to their predominantly African-American race, but may result from more disease-specific factors. Practice implications: Healthcare providers should take particular care in recognizing and demonstrating recommended communication skills with SCD patients as these patients may be particularly vulnerable to, and cognizant of, poor quality interactions.