Patients reporting better experiences of empathy in the first 12 months after diagnosis have a significantly lower risk of death over the subsequent 10 years, compared to those who experienced low practitioner empathy.
The study, which was largely funded by the National Institute for Health Research (NIHR), the Medical Research Council and Wellcome, found that patients who have been diagnosed with diabetes are at lower risk of early death if they have a doctor whom they describe as showing empathy towards them.
The concept of clinical empathy, which is the skill of understanding what a patient says and feels while effectively communicating this understanding to the patient, has been viewed as very important within healthcare for a long time, to the point where it is now emphasised in policy, codes of practice, national clinical guidance and medical training.
To find out more about the role that empathy plays in healthcare in the UK, researchers at Cambridge followed up with 867 individuals across 49 general practices in the UK. This was part of the ADDITION-Cambridge study to examine the association between the empathy of primary care practitioners (GPs and nurses) and the incidence of cardiovascular disease events (such as heart attack and stroke) or death.
Given the growing prevalence of diabetes in the UK, optimising management of this condition is a public health priority at the moment. Type 2 diabetes affects around 4m people in the UK and is associated with significant risk of death from heart disease or stroke, as well as early death. According to University of Cambridge, Type 2 diabetes costs the UK over £9bn annually, which is 10pc of the NHS budget.
In the study of 867 individuals, patients assessed their GP’s empathy and their experiences of diabetes care a year after their diagnosis, using the consultation and relational empathy (CARE) questionnaire. The results of these questionnaires were released yesterday (8 July) in the Annals of Family Medicine.
The human side of healthcare
The researchers behind the study reported that, of 628 participants who completed the questionnaire, just under one in five (19pc) experienced a cardiovascular disease event and a similar number (21pc) died during follow up from causes including cancer and cardiac arrest.
Interestingly, patients reporting better experiences of empathy in the first 12 months after diagnosis had a significantly lower risk (40-50pc) of death over the subsequent 10 years compared to those who experienced low practitioner empathy.
Researchers also reported that participants who noted that they experienced better empathy tended to have a slightly lower risk of cardiovascular disease events, “though this was not statistically significant”.
Dr Hajira Dambha-Miller, a GP and researcher at the UK Department of Public Health and Primary Care, worked on this study with University of Cambridge and said: “Our findings suggest that these more human elements of healthcare, early in the course of diabetes may be important in their long-term health outcomes. The potential impact is considerable and is comparable to prescribing medicines but without the associated problems of side effects or non-adherence.”
Dambha-Miller also noted that the UK’s current plan to “manage the growing burden of chronic preventable disease” is to turn to target-driven care and technology-based assessment, which removes the “interpersonal empathic aspects of care”, and results in doctors reducing their focus on the human side of care.
The research stated that it is possible that greater empathy results in lower levels of anxiety and a more optimistic outlook for patients, as it is already established that these traits help patients to live longer lives.
In a statement, Cambridge University also said, “It is possible that GPs with empathic, patient-centred skills may be more likely to succeed in promoting positive behavioural change such as medication adherence or physical activity. Previous studies have also reported that greater practitioner empathy is associated with higher patient motivation towards activation, enablement and self-management of disease.”
It may also simply be the case that clinical empathy “may also reflect the doctor’s listening ability and the trust of the patient in disclosing what is really wrong so that it can be addressed”.