The effects of patient communication skills training on compliance

OBJECTIVE: To examine the relationship between communication skills training for patients and their compliance with recommended treatment. DESIGN: A randomized control design was used, with patients nested within physicians. Each physician was audiotaped with 6 patients, 2 patients in each of the 3 intervention conditions: (1) a trained group (n = 50) received a training booklet in the mail 2 to 3 days prior to the scheduled appointment, (2) an informed group (n = 49) received a brief written summary of the major points contained in the training booklet while in the waiting room prior to the scheduled appointment, and (3) an untrained group (n = 51) did not receive any form of communication skills intervention. SETTING: Participants included physicians and patients from 9 different primary care, family practice locations. Two locations were clinics associated with a large, university-based medical school and hospital, while 7 were private practice offices in the community. PARTICIPANTS: The sample included 25 family physicians (averaging 11 years postresidency) and 150 patients. Patients were randomly selected from appointment records and randomly assigned to 1 of 3 intervention conditions. INTERVENTION: A training booklet designed to instruct patients in information seeking, provision, and verification. MAIN OUTCOME MEASURE: Patients' compliance with medications, behavioral treatment (e.g., diet, exercise, smoking cessation), and/or follow-up appointments and referrals. RESULTS: Trained patients were more compliant overall than untrained or informed patients. Training positively influenced compliance with behavioral treatments and follow-up appointments and referrals. CONCLUSION: Training patients in communication skills may be a cost-effective way of increasing compliance and improving the overall health of patients.