Excellent Patient-Provider Communication May Mitigate Racial and Ethnic Disparities in Diabetes Care Management Among...

Area of Science:

• Health Services Research
• Oncology
• Endocrinology

Background:

• Cancer survivors with diabetes require high-quality care to prevent complications.
• Racial and ethnic disparities exist in diabetes care, potentially impacting disease management.
• This study investigated disparities in diabetes management among cancer survivors and the role of patient-provider communication (PPC).

Purpose of the Study:

• To examine racial and ethnic disparities in diabetes management among cancer survivors.
• To assess the influence of patient-provider communication (PPC) quality on diabetes care adherence.
• To identify how PPC impacts guideline-concordant diabetes care across different racial and ethnic groups.

Main Methods:

• Retrospective cross-sectional analysis of Medical Expenditure Panel Survey data (2008-2021).
• Study population: diabetic cancer survivors reporting PPC quality and diabetes care utilization.
• Outcomes: adherence to diabetes guidelines (≥2 HbA1c tests, annual foot/eye exams) based on excellent vs. less than excellent PPC.

Main Results:

• Excellent PPC was associated with higher odds of guideline-adherent care for Hispanic and Asian survivors.
• Specifically, Hispanic survivors with excellent PPC had increased odds for HbA1c tests, foot, and eye exams.
• Asian survivors with excellent PPC showed higher odds for HbA1c tests and foot exams.
• Non-Hispanic Black survivors with excellent PPC had lower odds of receiving all three diabetes screenings.
• Non-Hispanic White survivors showed modestly higher odds for foot and eye exams with excellent PPC.

Conclusions:

• The impact of excellent PPC on diabetes management for cancer survivors varies significantly by race and ethnicity.
• Excellent PPC improved diabetes screening adherence for Hispanic and Asian survivors.
• Conversely, excellent PPC was linked to poorer diabetes management outcomes for Non-Hispanic Black survivors.
• Systemic factors likely contribute to the observed inverse association between excellent PPC and diabetes care for Black cancer survivors.