Association of Patient-Provider Teach-Back Communication with Diabetic Outcomes: A Cohort Study

Background and Objectives: The purpose of this study is to examine the patterns of patient teach-back experience (also known as "interactive communication loop") and determine its association with risk for diabetic complications and hospitalization, and health expenditures among individuals with diabetes. Methods: A retrospective cohort study of 2901 US adults aged 18 years or older with a confirmed diagnosis of diabetes was conducted using data from the 2011 to 2016 Longitudinal Medical Expenditure Panel Survey. Survey-design adjusted multivariable models were used to examine whether having patient teach-back experience at the baseline year (Year 1) is associated with development of diabetic complications, hospitalization, and health expenditure at follow-up year (Year 2). Health expenditures were adjusted for inflation and expressed in 2017 US dollars. All adjusted models included patient sociodemographic and clinical characteristics. Results: Analyses found that patients with teach-back experience were less likely to develop diabetic complications (adjusted odds ratio [AOR], 0.70; 95% CI, 0.52-0.96) and be admitted to the hospital due to diabetic complications (AOR, 0.51; 95% CI, 0.29-0.88) at 1-year followup. Patients having teach-back experience also had a significantly smaller increase in total expenditures of $1920 compared with those not having teach-back of $3639 (a differential change of -$1579; 95% CI, -$1717 to -$1443; P < .001). Conclusions: Teach-back could be an effective communication strategy that has potential to improve health outcomes, resulting in savings in diabetes care.