Techniques for Clinical Practice: Communication Strategies for Black Patients with Serious Illness

      As our population continues to age, the prevalence of serious illness—“a condition that carries a high risk of mortality, negatively impacts quality of life and daily function, and/or is burdensome in symptoms, treatments, or caregiver stress”
      • Kelley AS.
      Defining “serious illness.
      — is increasing. For patients with serious illness, communication with clinicians about which medical interventions align with their goals, values, and priorities has been shown to improve quality of life while reducing inappropriate healthcare costs.
      • Zhang B
      • Wright AA
      • Huskamp HA
      • et al.
      Health care costs in the last week of life: associations with end of life conversations.
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        • Kelley AS.
        Defining “serious illness.
        J Palliat Med. 2014; 17 (-985): 985
        • Zhang B
        • Wright AA
        • Huskamp HA
        • et al.
        Health care costs in the last week of life: associations with end of life conversations.
        Arch Intern Med. 2009; 169: 480-488
      1. Smith CB, Pintova S, Adelson KS, et al. Disparities in length of goals of care conversations between oncologists and patients with advanced cancer. J Clin Oncol. 36:Supp 19.

        • Johnson KS.
        Racial and ethnic disparities in palliative care.
        J Palliat Med. 2013; 16: 1329-1334
        • Carroll AE.
        Health disparities among black persons in the US and addressing racism in the health care system.
        JAMA Health Forum. 2020; 1e200769
        • Hall WJ
        • Chapman MV
        • Lee KM
        • et al.
        Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review.
        Am J Public Health. 2015; 105: 17
        • Starr LT
        • O'Connor NR
        • Meghani SH
        Improved serious illness communication may help mitigate racial disparities in care among black americans with COVID-19.
        JGIM. 2021; (Published online)
        • Cole AP
        • Nguyen DD
        • Meirkhanov A
        • et al.
        Association of care at minority-serving vs. non–minority-serving hospitals with use of palliative care among racial/ethnic minorities with metastatic cancer in the United States.
        JAMA Netw Open. 2019; 2e187633
        • Barnato AE
        • Anthony DL
        • Skinner J
        • Gallagher PM
        • Fisher ES.
        Racial and ethnic differences in preferences for end-of-life treatment.
        JGIM. 2009; 24: 695-701
        • Gordon HS
        • Street RL
        • Sharf BF
        • Souchek J.
        Racial differences in doctors’ information-giving and patients’ participation.
        Cancer. 2006; 107: 1313-1320