Study reveals barriers to effective doctor-patient communication

September 06, 2000

Patients with chronic heart failure often feel unable to ask their doctors questions about their illness and believe that doctors are reluctant to provide them with too much knowledge, finds new research in this week's British Medical Journal. The study suggests that more effective communication between doctors and heart failure patients is urgently needed.

Researchers in London interviewed 27 chronic heart failure patients aged 38-94 years about the effect heart failure had on their everyday lives. Most patients lacked a clear understanding of why they had developed heart failure, what it was, and what this implied for them. Many felt that their symptoms were a result of growing older and believed that nothing could be done. Although some patients were apparently unaware of their likely prognosis, most patients saw death as inevitable but felt that doctors were reluctant to talk about death or dying. One patient stated: "I think they like to keep things away from the patient."

Patients also described several barriers to communication with their doctors, including difficulties in getting to hospital appointments, confusion, short-term memory loss and the belief that doctors did not want to give patients too much information about their illness or its treatment.

The general lack of knowledge of chronic heart failure highlights the importance of patient education and information, say the authors. Some patients may benefit from more open communication about death and dying, and strategies to help patients ask questions should be developed, particularly given that chronic heart failure has a worse prognosis than many cancers, they conclude.
Contact: Angela Rogers, Research Associate, Guy's, King's and St. Thomas's Medical School and St. Christopher's Hospice, London Fax: +44 (0)20 7346 3864

(Knowledge and communication difficulties for patients with chronic heart failure: qualitative study. British Medical Journal, Volume 321, pp. 605-607.)

For further information about the British Medical Journal or to obtain a copy of the article, please contact Public Affairs Division, British Medical Association, BMA House, Tavistock Square, London WC1H 9JP, Tel: 020 7383 6254 or email: After 6 p.m. and on weekends telephone: +44 (0)208 241 6386 / +44 (0)208 997 3653/+44 (0)208 674 6294 / +44 (0)1525 379792 / +44 (0)208 651 5130.

Posted by the Center for the Advancement of Health <>. For information about the Center, call Petrina Chong, <> (202) 387-2829.

Center for Advancing Health

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