Words That Heal: A Systematic Review of Healthcare Providers-Patient Communication to Enhance Chronic Care Management and Practice Recommendations.

Abstract

Chronic diseases represent a major global health burden, and suboptimal treatment adherence remains a key obstacle to long-term management. Healthcare provider (HCP)-patient communication is a modifiable determinant of adherence and psychological functioning, yet evidence remains fragmented across conditions and communication domains. This review builds on patient-centered communication scholarship and established models of communication functions and pathways linking clinician-patient communication to health outcomes. This systematic review synthesizes empirical evidence on HCP-patient communication strategies associated with treatment adherence and psychological outcomes among adults with chronic diseases, including diabetes, cancer, cardiovascular, and respiratory conditions. Following PRISMA guidelines and PROSPERO registration (CRD42020171690), five databases (Scopus, PubMed, PsycINFO, Cochrane Library, Google Scholar) were searched. Results: Twenty-seven studies met the inclusion criteria. Communication strategies clustered into four macro-domains: (1) trust and interpersonal relationship; (2) information exchange and decision processes; (3) active involvement, empowerment, and autonomy; and (4) change processes, emotional regulation, and management of difficulties. Domains were defined a priori from patient-centered communication, self-management, and behavior-change literature and refined during data extraction. Across conditions, integrated communication patterns addressing multiple domains were generally associated with favorable adherence, self-management, clinical, quality-of-life, and healthcare-utilization outcomes, although evidence strength varied by study design, disease context, and methodological quality. Findings support a provisional, evidence-informed framework in which HCP-patient communication strategies, organized within relational, informational, participatory, and change-regulatory macro-domains, may engage proximal regulatory processes that, in turn, may be associated with adherence and other chronic-care outcomes. Prospective studies are needed to test these pathways.