Higher BMI associated with shorter visits in male oncology patients: An exploratory analysis

To determine the potential relationship between measures of patient-provider communication and patient body mass index (BMI) and gender in cancer care.

We audio-recorded cancer patients' communication with their clinicians in an academic medical oncology practice from 2012-2014. We coded audio-recordings with the Roter Interaction Analysis System. We then examined whether BMI was associated with patient centeredness, time with doctor, global affect, and patient self-reported communication quality. Univariate associations with BMI were assessed with Chi-square and Kruskal-Wallis tests. A cumulative logit model adjusted for patient and visit characteristics in a multivariable model.

We recorded 327 patient interactions with 37 clinicians. After adjusting for patient sex, and visit characteristics, visit length, patient-centeredness, global affect (patient or clinician) and satisfaction did not differ. However, higher BMI was associated with shorter visit length, and lower Negative Global Affect (p = 0.03 and p = 0.03, respectively) in men only.

In this exploratory analysis, communication characteristics did not vary by patient BMI overall. However, in men, higher BMI was associated with shorter visit length and more negative affect. Those differences did not persist after adjusting for multiple comparisons.

Patient body size may contribute to clinical communication in cancer care, particularly for obese men.