The association between patient's experience of empathy and self-reported health status in a large multisite primary care trial.

Abstract

The authors report a secondary analysis from a large, multisite, pragmatic trial focused on increasing the degree of behavioral health and primary care service integration. In this analysis, the authors tested for an association between patients' reports of their clinicians' clinical empathy and the patients' self-reported physical and mental health status. At two time points across 24 months, 3929 adult patients with chronic medical and behavioral conditions completed the Consultation and Relational Empathy (CARE) measure and the Patient-Reported Outcomes Measurement Information System (PROMIS-29) survey. The CARE was divided into 4 empathy ranges from lowest (median 31) to highest (median 50). While controlling for 49 practice and patient characteristics, the authors tested for an association between empathy range and self-reported physical and mental health (PROMIS). In adjusted analyses, moving from the lowest to the highest empathy range increased PROMIS (range 20-66) mental health by 2.4-3.0 points and physical health by 1.9-3.2 points. All the models were highly significant. These associations were not explained by any of the 49 measured confounders. The self-reported health status of primary care patients with multiple chronic conditions is positively correlated with the patient's experience of their clinician's empathy. It is unclear if empathic care is responsible for better outcomes, if better health engenders higher reports of empathy, or if both are caused by a third, unmeasured factor. This finding adds to the evidence that empathic care is associated with improved patient-centered health outcomes. Providing primary care services that patients experience as high in empathy is a promising strategy for improving physical and mental health.