2021 CMSC Annual Meeting

The Art of the Patient Conversation: Advanced Practice Provider Perspectives to Improve Outcomes in Multiple Sclerosis


Background: Robust health literacy, defined by the Centers for Disease Control and Prevention as the degree to which an individual can obtain, communicate, and understand health information/services, is key to helping patients improve their outcomes and is particularly important for individuals managing chronic illnesses such as multiple sclerosis (MS). Low health literacy in people living with MS has been associated with negative health behaviors and increased emergency room visits. Variable levels of health literacy among patients also impacts effective communication between providers and patients. As healthcare providers (HCPs) continue to strive towards optimal patient-centric care, it is critical to raise awareness of conversational techniques and enhance practice behaviors for effective communication with people living with MS. Objectives: Share multimodal strategies that HCPs may implement during patient conversations to meet the needs of people living with MS with varying health literacy levels. Methods: We, as practicing advanced practice providers, discussed conversational tactics used in our clinical practice and reviewed the literature on health literacy best practices. Our group shared their perceptions of common discourses during past patient conversations. We devised practical, yet impactful, conversational strategies for providers to adopt in their practices. Results: Based on our discussions of past patient conversations, frequent topics that arose included: what information to look for and where, reliable versus unreliable sources, and what type of language is overpromising. Misunderstandings may be fuelled by misleading information found online and/or on social media. We further found that patient resources outlining the basics of healthcare helped support better conversations. Informed by these learnings, we suggest four practical strategies for adoption by HCPs: (1) plain-language techniques, (2) teach-back, (3) open-ended questions, and (4) active listening/paraphrasing. Conclusions: Open communications between HCPs and people living with MS are important for meeting individual patient needs. HCPs may equip themselves with the strategies we outline to ensure comprehensive conversations, thereby optimizing interactions with patients and building trustworthy foundation for shared decision-making.