Practitioner empathy and the duration of the common cold

Abstract

Objective: This study's objective was to assess the relationship of empathy in medical office visits to subsequent outcomes of the common cold.

Methods: A total of 350 subjects ? 12 years of age received either a standard or enhanced physician visit as part of a randomized controlled trial. Enhanced visits emphasized empathy on the part of the physician. The patient-scored Consultation and Relational Empathy (CARE) questionnaire assessed practitioner-patient interaction, especially empathy. Cold severity and duration were assessed from twice-daily symptom reports. Nasal wash was performed to measure the immune cytokine interleukin-8 (IL-8).

Results: Eighty-four individuals reported perfect (score of 50) CARE scores. They tended to be older with less education but reported similar health status, quality of life, and levels of optimism. In those with perfect CARE scores, cold duration was shorter (mean 7.10 days versus 8.01 days), and there was a trend toward reduced severity (mean area under receiver-operator characteristics curve 240.40 versus 284.49). After accounting for possible confounding variables, cold severity and duration were significantly lower in those reporting perfect CARE scores. In these models, a perfect score also correlated with a larger increase in IL-8 levels.

Conclusions: Clinician empathy, as perceived by patients with the common cold, significantly predicts subsequent duration and severity of illness and is associated with immune system changes.

Figure 1

Graph of CARE score distribution (n=350): Perfect score (n=84) versus non-perfect score (n=266)

Figure 2

Log rank test for equality of survivor functions p value 0.0803. This unadjusted graphic of time post-enrollment until the end of the individual’s cold shows the proportion with a cold is typically less within the perfect CARE score group when compared to the non-perfect CARE score groups.