Congratulations to CFS core faculty member, Dr. Gabriella Modan who, along with her collaborators, Dr. Seuli Bose Brill (General Internal Medicine) and Nathan Richards (PhD Student, English) received a $12,000 Global Arts + Humanities Discovery Theme Grant for Talking in the Clinic: Barriers and Facilitators of Chronic Disease Adherence among Patients at High Risk for Covid-19 Complications.

In the absence of pharmacologic and preventive measures for Covid-19, what the healthcare system is able to offer patients at high risk for Covid-19 complications is management of chronic disease; yet, patients with complex chronic disease (multiple co-morbid diseases or hard-to-control disease) are more likely than healthy patients to have barriers to care adherence. Using methodological and theoretical approaches from sociolinguistics and academic medicine, this study aims to identify patient reported barriers to care adherence and the different ways that healthcare providers can encourage (or, conversely, thwart) discussion of those barriers during clinical encounters. There is little data from patients’ perspectives on their barriers, thus, in order to develop recommendations that may lead to improved care adherence, a detailed understanding of what those barriers are, especially from the patient perspective, is necessary. Barriers themselves and discussions about them are present in clinical encounters making it a rich site for revealing these problems and improving patients’ care adherence.

At a time when pharmacologic measures are not available to treat or prevent Covid-19, promoting chronic disease control and empowering patients to adhere to care plans is of central importance to mitigating the complications that arise from Covid-19 for the most vulnerable patients. This study focuses squarely on interactions where physicians and patients comment directly on chronic disease management factors, thus providing valuable insights, from their own perspectives, about barriers to care access and adherence. In doing so we are poised to offer linguistic strategies to physicians that encourage open discussion of barriers and avoid miscommunications between both parties. Further, building on our analyses, we can equip health systems and payers to make targeted investments to promote chronic disease control, and thus decrease Covid-19 risk.