Patient Trust and Medical Mistrust Toward Overactive Bladder Therapies: General Consumer Awareness and Perceptions.

Area of Science:

• Urology
• Patient-Physician Communication
• Health Literacy

Background:

• Overactive bladder (OAB) significantly impacts quality of life, yet many patients delay or avoid treatment.
• The role of physician-patient concordance, particularly gender concordance, in fostering trust for OAB care is not well understood.
• Understanding factors influencing patient trust is crucial for improving engagement with OAB treatments, including minimally invasive therapies (MIT).

Purpose of the Study:

• To evaluate the association between physician gender concordance and patient trust in the context of overactive bladder (OAB) care.
• To examine the relationship between patient trust and health literacy, medical mistrust, and treatment preferences for OAB.
• To identify key factors influencing patient trust to enhance engagement with OAB management strategies.

Main Methods:

• A survey-based study involving 1,027 U.S. consumers randomized to view OAB treatment videos differing by physician race and gender.
• Assessment of patient trust using a dichotomized 4-point Likert scale.
• Measurement of health literacy (eHealth Literacy Scale) and medical mistrust (Group-Based Medical Mistrust Scale), alongside OAB diagnosis and MIT preferences.

Main Results:

• Physician gender concordance was not significantly associated with patient trust (p>0.05).
• Patient trust was strongly associated with having an overactive bladder (OAB) diagnosis (p=.001) and selecting minimally invasive therapies (MIT) (p<.001).
• Higher eHealth literacy independently increased trust (OR 1.06, p<.001), while greater medical mistrust reduced trust (OR 0.94, p<.001); income was also associated with trust.

Conclusions:

• Increased patient trust is associated with a higher likelihood of OAB diagnosis and selection of MIT.
• Health literacy and medical mistrust are more significant predictors of patient trust in OAB care than physician gender concordance.
• Targeting health literacy and addressing medical mistrust may be key strategies for improving patient engagement in overactive bladder (OAB) management.