Examining the association between perceived quality of patient-provider relationships and provider avoidance, CAM use, and CAM use disclosure

Patients' perceptions of the quality of their relationships with health care providers may influence their interactions with providers and health care seeking behavior. For example, patients who view their relationships with health care providers negatively may avoid providers, and they may seek alternative types of health care and therapies, including complementary and alternative medicine (CAM). Additionally, these patients may be less likely to disclose their use of CAM to their providers, which is an essential component of effectively coordinating CAM and conventional care. The objective of this study was to examine the association between perceived quality of patient-provider relationships and provider avoidance, as well as use and disclosure of CAM. Data come from the 2007 Health Information National Trends Survey, which used a dual-mode telephone and mail multistage sampling design. Data were weighted to make the results representative of the U.S. population 18 years and older. In logistic regression analyses adjusting for sociodemographic characteristics, having a regular source of care, and health status, poorer perceived quality of patient-provider relationships was significantly associated with provider avoidance (AOR = 2.40, CI: 1.47, 3.93) and CAM use (AOR = 2.39, CI: 1.18, 4.83), but not with disclosure of CAM use. Our findings suggest that further research to examine the impact of patient-provider relationships on patient behavior is warranted. In particular, studies are needed that examine the quality of patient-provider relationships in greater depth, explore its association with use of different CAM modalities, and examine additional predictors of CAM disclosure.