The other half of the whole: teaching patients to communicate with physicians.

BACKGROUND AND OBJECTIVES A wide body of research suggests that the nature of communication between patients and physicians is strongly related to health outcomes. Interventions that involve teaching patients to communicate with physicians are important to assess in this context. METHODS We conducted a review of randomized controlled trials (RCTs) in the outpatient setting from 1975 to 2000. Patient communication interventions were classified as high, medium, or low intensive, depending on the length of the intervention, use of personnel, and estimated cost. Characteristics of 16 studies were examined, including sample populations, types of interventions, and the nature of health outcomes. RESULTS Patient improvement in a variety of outcomes as a result of communication training was demonstrated. Positive change variables included patient communication, medical outcomes, functional status, and adherence to treatment. Studies revealed mixed findings on the outcome of patient satisfaction. All US studies suggested that pre-visit training had no effect on the overall length of the medical visit. CONCLUSIONS Studies indicated improvement in a variety of patient outcomes. However, the wide variation in study design, interventions, and outcomes hinders the ability to draw well-founded conclusions. Future research needs to further address biopsychosocial outcomes, cost-effectiveness, and their relationship.