PARE0016 The role of empathy quotient in patient-physician communication: a tool to improve medication adherence
Authors: A. Celano
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Brain circuits governing the identification with others and those regulating the care feeling towards suffering people form wide distinct brain networks and are essential elements of empathy. This last is ruled by the “circuit of empathy” involving ten interconnected brain areas, operating on a personal base. This explains why some people have little or no empathy, and consequently, high or low propensity to communicate effectively: lower “empathy quotient” leads to inadequate social competence. The circuit of empathy is a very sophisticated and complex system, and its erosion is due to both genetic (deficiencies) and environmental (life experiences) factors. <h3>Objectives</h3> The EQ increase is essential to improve patient-physician communication and enhance medical adherence. It is easy to achieve it by promoting the ability to understand others’ feelings and thoughts and to interpret signals and experience (beyond the symptoms), as well as by using effective communication. Being open improves quality and effectiveness of the patient-physician relationship, as well as medical adherence. <h3>Methods</h3> Observation, EQ measurement on patients and health personnel—APMAR carried out an observation activity to evaluate possible EQ improvement in patients and health personnel, and enhance medication adherence. Interventions were classified based on target (patient/health personnel), focus (educational/behavioural/affective), implementation (general/customized), complexity (one or more aspects) and the operator involved, followed by specific evaluation on adherence and disease outcomes. Patients suffering from rheumatological diseases and health personnel were interviewed to collect psychosocial information and indicatively measure their EQ. This allowed to act directly on parameters determining empathy improvement. Effective engagement was achieved through diagnostic alliance*, therapeutic alliance*, disease self-awareness, medication adherence and self-administration. 78 patients and 10 health personnel followed a training to improve EQ and ability to relate effectively through communication, narrative and psychodynamic. Health personnel followed an experiential and practical training, with cognitive, emotional and behavioural elements inspired by psychodynamic, Gestalt, AT, NLP, to learn how to use situational logic, modulate tone of voice, speech quality and speed, gestures, also using NBM principles. 30-minute individual monthly consultations and cognitive-behavioural therapy were conducted. <h3>Results</h3> Interventions showing some impact on medication adherence were direct, personalized on the patient and mediated by the health personnel. Disease outcomes, patients’ self-care education and decision-making were considered, and a gym program was included. Follow-up occurred every 2 months (total 10 months); 86% of patients were adherent and the program significantly improved disease outcomes such as DAS28, pain, exacerbations, functional disability and quality of life. <h3>Conclusions</h3> The EQ increase is essential to improve patient-physician communication and to enhance medical adherence. <h3>Reference</h3> [1] <i>Antonella Celano, APMAR President</i><i>Rosario Gagliardi, Professor of Socio-medical Management and Medical Communication, MIAS Master – Università La Sapienza, Rome</i> <h3>Disclosure of Interest</h3> None declared