Educational Program Seen to Aid Doctor-Patient Communication and Care Among Black Women in US

An educational self-management program can benefit African-American women with systemic lupus erythematosus (SLE), improving doctor-patient communication and helping patients manage side effects of their medications, a new study suggests.

“Health service utilization among African American women living with systemic lupus erythematosus: perceived impacts of a self-management intervention” was published in the journal Arthritis Research & Therapy. 

Access to, and use of, quality healthcare is critical for anyone with a chronic disease — but such it’s not guaranteed, especially for historically disenfranchised groups like black Americans. Educational programs can help, both by giving patients more tools to manage their disease on their own and by improving patient-caregiver communication.

Researchers wanted to know how participants perceived one such educational program, called the Chronic Disease Self-Management Program (CDSMP), which is described in the study as “a group-based workshop designed to foster self-efficacy and encourage patients to actively partner with their healthcare providers to optimize their care.”

This intervention is thought to be particularly cost-effective and able to be implemented nationwide.

The researchers selected 24 people from a group of 150 female African-American SLE patients participating in CDSMP (NCT02988661). The 24 were specifically chosen so that the sample would cover the range of SLE disease manifestations, as well as different demographic features like age and education.

Participants were slated to participate in two semi-structured interviews, one before CDSMP and one after. However, six people only attended one CDSMP session, so they did not undergo a second, detailed interview.

Looking at what patients said, qualitatively, the researchers observed that, before CDSMP, 10 (41.7%) of those interviewed expressed dissatisfaction with how they communicated with their doctor. After CDSMP, this number dropped to 11.1%.

The proportion of patients who expressed satisfaction with managing medication side effects also increased to 41.2% from 12.5%.

Researchers noted that insurance coverage, which was not a predetermined topic for the semi-structured interviews, “emerged organically” as an important topic for how the participants used healthcare.

Only three participants reported a tangible improvement in coverage after CDSMP, using more available services and negotiating for better benefits. Still, this finding does highlight the need for better and more effective coverage.

“This work is part of an ongoing study funded by the National Institute on Minority Health and Health Disparities to examine the effectiveness of the CDSMP among African American women with SLE,” Cristina Drenkard, MD, PhD, a professor at Emory and study co-author, said in a press release. “As we know, African American women are a population vulnerable to high rates of SLE morbidity and mortality.”

“As the CDSMP is a nationwide disseminated generic intervention, it can be accessible to socioeconomically disadvantaged people with SLE, and potentially facilitate reduction in use of healthcare service through improved self-management behaviors,” she added. “Our findings suggest that African American women living with SLE perceived benefits from CDSMP participation on healthcare engagement. Should further quantitative results reach similar conclusions, providers should encourage African American women with SLE to participate in this widely available self-management program.”