Interventions that strengthen the patient-clinician relationship improve healthcare outcomes: An updated systematic review and meta-analysis.
Saved in:
| Title: | Interventions that strengthen the patient-clinician relationship improve healthcare outcomes: An updated systematic review and meta-analysis. |
|---|---|
| Authors: | Neal, David P.1 (AUTHOR) d.n.neal@amsterdamumc.nl, Nestor, Bridget A.1,2,3,4 (AUTHOR) bnestor@endicott.edu, Archer, Camille1,2,5 (AUTHOR) carcher@mail.endicott.edu, Molinari-Ulate, Mauricio1,6 (AUTHOR) mauricio.molinari@ucr.ac.cr, Wild, Marcus G.1,7 (AUTHOR) marcus.wild@va.gov, Kelley, John M.1,2,8 (AUTHOR) jkelley@endicott.edu |
| Source: | Patient Education & Counseling. Sep2026, Vol. 150, pN.PAG-N.PAG. 1p. |
| Subject Terms: | *Evidence synthesis, *Quality of life, Physician-patient relations, Health outcome assessment, Medical care use, Randomized controlled trials |
| Abstract: | This review updates a prior meta-analysis which suggested that clinician-focused interventions that strengthen the patient-clinician relationship improve healthcare outcomes. It also extends the previous meta-analysis with additional moderator and sensitivity analyses. This pre-registered systematic review (PROSPERO CRD42024554571) followed PRISMA guidelines. We searched Medline and EMBASE for randomized controlled trials published from November 2012 to June 2024, which compared any clinician-focused intervention to strengthen patient-clinician relationships with controls. Eligible outcomes were objective or validated subjective measures of physical health, health related quality of life, or healthcare resource use. Two investigators completed data extraction, and risk of bias assessment using the RoB2 tool. Random effects meta-analyses were performed. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were reported. Potential moderators investigated were intervention type, review wave (original vs. update), and trial duration. Twenty-eight randomized controlled trials (original review = 13, newly added = 15) comprising 18,046 patients met inclusion criteria. Interventions to improve the patient-clinician relationship were superior to attention-matched controls across a variety of healthcare outcomes (SMD = 0.223, 95% CI: 0.071–0.376, p = 0.004). High heterogeneity was present (Q(27) = 526.43, p <.001; I² = 94.9%), including an important outlier, and GRADE assessment showed certainty of evidence was low. Moderator analyses showed no significant effects. Interventions that strengthen patient-clinician relationships have small but significant effects on healthcare outcomes. Although heterogeneity between included studies is a limitation, the effect cannot be ascribed to differences in consultation duration or frequency, and the effect is observed across multiple clinical settings and health conditions. Health care professionals should embrace existing interventions, including training and resources, that have been shown to strengthen patient-clinician relationships. Health systems should support large-scale implementation of such interventions, not only to improve satisfaction but to achieve better healthcare outcomes. • Interventions that strengthen patient-clinician relationship improve healthcare outcomes • Effect size of relationship interventions as large as or larger than previous reports • Beneficial effect of relationship interventions applies in multiple clinical disorders • Relationship impact on population health outcomes may rival specific treatments [ABSTRACT FROM AUTHOR] |
| Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Education Research Complete |
| FullText | Text: Availability: 0 |
|---|---|
| Header | DbId: ehh DbLabel: Education Research Complete An: 195068750 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Interventions that strengthen the patient-clinician relationship improve healthcare outcomes: An updated systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Neal%2C+David+P%2E%22">Neal, David P.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> d.n.neal@amsterdamumc.nl</i><br /><searchLink fieldCode="AR" term="%22Nestor%2C+Bridget+A%2E%22">Nestor, Bridget A.</searchLink><relatesTo>1,2,3,4</relatesTo> (AUTHOR)<i> bnestor@endicott.edu</i><br /><searchLink fieldCode="AR" term="%22Archer%2C+Camille%22">Archer, Camille</searchLink><relatesTo>1,2,5</relatesTo> (AUTHOR)<i> carcher@mail.endicott.edu</i><br /><searchLink fieldCode="AR" term="%22Molinari-Ulate%2C+Mauricio%22">Molinari-Ulate, Mauricio</searchLink><relatesTo>1,6</relatesTo> (AUTHOR)<i> mauricio.molinari@ucr.ac.cr</i><br /><searchLink fieldCode="AR" term="%22Wild%2C+Marcus+G%2E%22">Wild, Marcus G.</searchLink><relatesTo>1,7</relatesTo> (AUTHOR)<i> marcus.wild@va.gov</i><br /><searchLink fieldCode="AR" term="%22Kelley%2C+John+M%2E%22">Kelley, John M.</searchLink><relatesTo>1,2,8</relatesTo> (AUTHOR)<i> jkelley@endicott.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Patient+Education+%26+Counseling%22">Patient Education & Counseling</searchLink>. Sep2026, Vol. 150, pN.PAG-N.PAG. 1p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22Evidence+synthesis%22">Evidence synthesis</searchLink><br />*<searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Physician-patient+relations%22">Physician-patient relations</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+use%22">Medical care use</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: This review updates a prior meta-analysis which suggested that clinician-focused interventions that strengthen the patient-clinician relationship improve healthcare outcomes. It also extends the previous meta-analysis with additional moderator and sensitivity analyses. This pre-registered systematic review (PROSPERO CRD42024554571) followed PRISMA guidelines. We searched Medline and EMBASE for randomized controlled trials published from November 2012 to June 2024, which compared any clinician-focused intervention to strengthen patient-clinician relationships with controls. Eligible outcomes were objective or validated subjective measures of physical health, health related quality of life, or healthcare resource use. Two investigators completed data extraction, and risk of bias assessment using the RoB2 tool. Random effects meta-analyses were performed. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were reported. Potential moderators investigated were intervention type, review wave (original vs. update), and trial duration. Twenty-eight randomized controlled trials (original review = 13, newly added = 15) comprising 18,046 patients met inclusion criteria. Interventions to improve the patient-clinician relationship were superior to attention-matched controls across a variety of healthcare outcomes (SMD = 0.223, 95% CI: 0.071–0.376, p = 0.004). High heterogeneity was present (Q(27) = 526.43, p <.001; I² = 94.9%), including an important outlier, and GRADE assessment showed certainty of evidence was low. Moderator analyses showed no significant effects. Interventions that strengthen patient-clinician relationships have small but significant effects on healthcare outcomes. Although heterogeneity between included studies is a limitation, the effect cannot be ascribed to differences in consultation duration or frequency, and the effect is observed across multiple clinical settings and health conditions. Health care professionals should embrace existing interventions, including training and resources, that have been shown to strengthen patient-clinician relationships. Health systems should support large-scale implementation of such interventions, not only to improve satisfaction but to achieve better healthcare outcomes. • Interventions that strengthen patient-clinician relationship improve healthcare outcomes • Effect size of relationship interventions as large as or larger than previous reports • Beneficial effect of relationship interventions applies in multiple clinical disorders • Relationship impact on population health outcomes may rival specific treatments [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=195068750 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/j.pec.2026.109699 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 1 StartPage: N.PAG Subjects: – SubjectFull: Evidence synthesis Type: general – SubjectFull: Quality of life Type: general – SubjectFull: Physician-patient relations Type: general – SubjectFull: Health outcome assessment Type: general – SubjectFull: Medical care use Type: general – SubjectFull: Randomized controlled trials Type: general Titles: – TitleFull: Interventions that strengthen the patient-clinician relationship improve healthcare outcomes: An updated systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Neal, David P. – PersonEntity: Name: NameFull: Nestor, Bridget A. – PersonEntity: Name: NameFull: Archer, Camille – PersonEntity: Name: NameFull: Molinari-Ulate, Mauricio – PersonEntity: Name: NameFull: Wild, Marcus G. – PersonEntity: Name: NameFull: Kelley, John M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 07383991 Numbering: – Type: volume Value: 150 Titles: – TitleFull: Patient Education & Counseling Type: main |
| ResultId | 1 |
