Article Figures & Data
Tables
- Table 1
Sociodemographic and Clinical Characteristics of Study Participants With Completed CARE Score in the ADDITION-Cambridge Study
Variable All Participants
n = 628CARE Score Tertiles Tertile 1 (≤37) n = 206 Tertile 2 (38-46) n = 215 Tertile 3 (>46) n = 207 Sociodemographic characteristics Male, No. (%) 376 (60) 119 (58) 128 (60) 129 (62) Age at baseline, y 61 (7.1) 59 (7.6) 60 (6.4) 61 (7.1) White, No. (%) 608 (97) 197 (96) 208 (97) 203 (98) Full-time employment >30 h per week, No. (%) 221 (35) 79 (38) 79 (37) 63 (30) Age >18 y when left full-time education, No. (%) 299 (48) 93 (45) 102 (47) 104 (50) Clinical characteristics HbA1c (%) 6.51 (0.86) 6.51 (0.80) 6.54 (0.79) 6.44 (0.95) HbA1c (mmol/mol) 48.0 (7.0) 48.0 (6.4) 48.0 (6.3) 47.0 (8.0) Triglycerides (mmol/L) 1.96 (1.38) 2.14 (1.39) 1.86 (1.96) 1.88 (1.74) LDL cholesterol (mmol/L) 2.46 (0.79) 2.29 (0.80) 2.47 (0.81) 2.41 (0.76) Total cholesterol (mmol/L) 4.49 (0.93) 4.57 (1.01) 4.53 (0.86) 4.35 (0.91) Systolic blood pressure (mm Hg) 135.4 (18.8) 136.6 (19.4) 133.7 (19.0) 135.6 (19.4) Diastolic blood pressure (mm Hg) 78.43 (9.7) 78.7 (9.2) 78.9 (10.9) 77.8 (9.4) ADDITION = Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen Detected Diabetes in Primary Care; CARE = consultation and relational empathy measure; HbA1c = glycated hemoglobin; LDL = low-density lipoprotein.
Note: Values are presented as mean (SD) unless otherwise stated. All values were obtained at baseline.
- Table 2
Association Between Experience of Empathy According to CARE Score and Incidence of CVD Events and Mortality in the ADDITION-Cambridge Study
CARE Score Category Number of Events Rate of Eventa Univariable HR (95% CI) P Value Multivariable HR (95% CI)b P Value CVD events CARE score, per-unit difference Tertile 1 28 1.59 1 1 Tertile 2 20 1.07 0.67 (0.38-1.19) .17 0.64 (0.35-1.14) .13 Tertile 3 23 1.27 0.80 (0.46-1.39) .42 0.66 (0.38-1.16) .16 Continuous per-unit CARE score 0.99 (0.97-1.02) .67 0.99 (0.96-1.01) .33 All-cause mortality CARE score, per-unit difference Tertile 1 29 1.55 1 1 Tertile 2 21 1.07 0.61 (0.35-1.07) .08 0.49 (0.27-0.88) .01 Tertile 3 25 1.32 0.86 (0.52-1.42) .55 0.60 (0.35-1.04) .05 Continuous per-unit CARE score 0.99 (0.97-1.01) .31 0.97 (0.95-0.99) .03 ADDITION = Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen Detected Diabetes in Primary Care; CARE = consultation and relational empathy measure; CVD = cardiovascular disease; HbA1c = glycated hemoglobin; HDL = high density lipoprotein; HR = hazard ratio; LDL = low-density lipoprotein.
Note: Estimates are from Cox proportional hazard regressions. Tertile 1 corresponds to CARE score ≤37, tertile 2 to CARE score 38-46, and tertile 3 to CARE score >46.
↵a Incident events per 100 person-years.
↵b Adjusted at baseline for age, sex, age at diagnosis, year of diagnosis, ethnicity, work status, education level, self-report medication use, total cholesterol level, triglyceride level, HDL cholesterol level, LDL cholesterol level, HbA1c level, systolic blood pressure, diastolic blood pressure, and trial group.
Additional Files
The Article in Brief
Association Between Primary Care Practitioner Empathy and Risk of Cardiovascular Events and All-Cause Mortality Among Patients With Type 2 Diabetes: A Population-Based Prospective Cohort Study
Hajira Dambha-Miller , and colleagues
Background It is hypothesized that better patient experiences of practitioner empathy could lead to better health outcomes.
What This Study Found A United Kingdom study designed to examine the association between primary care practitioner empathy and incidence of cardiovascular disease and all-cause mortality among type 2 diabetes patients found that those patients experiencing greater empathy in the year following their diagnosis saw beneficial long-term clinical outcomes. Using the consultation and relational empathy (CARE) questionnaire, which measures patients' experience of care with a focus on empathy, a numerical score for 628 participants from 49 general practices in East Anglia, UK, was computed 12 months after diagnosis. Those patients reporting better experiences of empathy had a lower risk (40-50%) of all-cause mortality over the subsequent 10 years compared with those reporting low practitioner empathy.
Implications
- While medicine moves increasingly towards precision, target-driven health care and technology-based assessment models, these findings suggest that interpersonal, empathic care may be an important determinant in the risk of mortality.
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