Role of GP empathy on patient-reported outcomes in telephone consultations: a cross-sectional study with validation of the Consultation and Relational Empathy (CARE) Measure.

Abstract

The Consultation and Relational Empathy (CARE) Measure is a validated measure of GP empathy in face-to-face consultations (FTFCs) and higher CARE scores predict better patient outcomes. However, the validity of the CARE Measure and its importance in telephone consultations (TCs) is unknown. To determine the validity and reliability of the CARE Measure in TCs, and the associations between CARE scores and outcomes in TCs compared with FTFCs. A cross-sectional survey, conducted in 2018, of 1023 patients who had a TC or FTFC with a GP in Scotland within the preceding 30 days. Validity and reliability testing of the CARE Measure was conducted using standard methods. Associations between low, medium, and high CARE scores and three patient outcomes (enablement, symptom change, and satisfaction) were determined using multilevel binary logistic regression. Out of the 1023 participants, 369 had TCs and 654 had FTFCs. The CARE Measure was found to be valid and reliable. In TCs, compared with the low CARE score group, a high CARE score was positively associated with enablement (adjusted odds ratio [aOR] 6.4, 95% confidence interval [CI] = 3.5 to 11.9), symptom improvement (aOR 5.7, 95% CI = 2.7 to 11.9), and satisfaction (aOR 20.1, 95% CI = 8.9 to 45.4). Findings were similar in FTFCs,and effects were not influenced by patient or consultation characteristics in either group. The CARE Measure is valid and reliable in TC. GP empathy, as measured by the tool, predicts better patient outcomes in TCs, similar to FTFCs. Given the common use of TC in primary care, strategies to support empathic communication are essential irrespective of consultation modality.