To investigate associations between patient communication ratings and
cardiometabolic medication adherence, we conducted a cross-sectional analysis of 9,377 patientsin the Diabetes Study of Northern California (DISTANCE), a race-stratified, random sample of
Kaiser Permanente survey respondents. Eligible participants received ≥1 oral hypoglycemic, lipidlowering,
or anti-hypertensive medication in the 12 months preceding the survey. Communication
was measured with a 4-item Consumer Assessment of Healthcare Providers and Systems Survey
(CAHPS) score and 4 items from the Trust in Physicians and Interpersonal Processes of Care
instruments. Poor adherence was >20% continuous medication gap for ongoing medications.
Using modified least squares regression, we calculated differences in poor adherence prevalence
for a 10-point decrease in CAHPS score and comparing higher vs. lower communication ratings
on other items, adjusting for necessary sociodemographic and medical confounders derived from a
directed acyclic graph.