scholarly journals Understanding Medication Adherence in Patients with Limited English Proficiency

2022 ◽  
Vol 15 (1) ◽  
pp. 345-350
Author(s):  
Luke Kahler ◽  
Joseph LeMaster

Introduction. Approximately 41.6% of the US population who speak a language other than English (20% over all) and have limited English proficiency (LEP) status.1 Health outcomes for patients with LEP status or who are language discordant (speak a different language than their clinicians) have been studied in several settings, including the hospital and outpatient, with results widely demonstrating that these patients have worse outcomes when a professional interpreter is not used consistently. 2,3 The aim of this study was to investigate the impact of preferred language and language discordance on medication adherence. Methods. Data were collected via review of pharmacy-acquired medication profiles for three primary language cohorts: Nepali, Spanish, and English. Total Days of Adherence, Adherence Ratio, and Maximum Days Non-adherent were calculated and compared between language groups. We examined these statistics for regular and long-acting insulin, metformin and ACE inhibitors, testing for differences between language groups and those who experienced greater vs less than the median value for language concordant clinical encounters. Results. The most adherent group over all (highest adherence-ratio) were the Nepali-speaking, but the results showed high variability across outcomes and medications. Conclusions. After adjustment and stratification for greater vs lesser language concordant patient visit experience, we found that language-spoken plays an important role in the clinical encounter, and that LEP patients could have improved outcomes in their adherence to medications by having providers who speak their language or use an interpreter.

2019 ◽  
Vol 18 (1) ◽  
pp. 32-39
Author(s):  
Seiichi Villalona ◽  
Christian Jeannot ◽  
Mery Yanez Yuncosa ◽  
W. Alex Webb ◽  
Carol Boxtha ◽  
...  

Introduction: Provider–patient language discrepancies can lead to misunderstandings about follow-up care instructions and decreased adherence to treatment that may contribute to disparities in health outcomes among patients with limited English proficiency (LEP). This observational study aimed to understand how emergency department (ED) staff went about treating patients with LEP and examine the impact of consistent interpretation modality on overall patient satisfaction and comprehension. Method: A cross-sectional study was conducted among Spanish-speaking patients with LEP presenting to the ED. A survey was administered at two different time points: after patients provided their history of present illness and after the patient received information regarding follow-up treatment. Results: Analysis of average visual analog scale (VAS) scores by consistency of interpretation suggested higher overall scores among participants that received care via the same communication modalities during both the history of present illness and at disposition, when compared with patients that did not. At both time points, video-based interpretation was associated with higher VAS scores in comparison to other modalities, whereas phone-based interpretation was associated with lower VAS scores. Conclusion: Providing consistent modes of interpretation to patient’s with LEP throughout their ED visits improved their overall satisfaction of care provided and understandings of discharge instructions.


2013 ◽  
Vol 51 (2) ◽  
pp. 178-184 ◽  
Author(s):  
Antonio Riera ◽  
Aledie Navas-Nazario ◽  
Veronika Shabanova ◽  
Federico E. Vaca

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029105 ◽  
Author(s):  
Kasey R Boehmer ◽  
Claudia C Dobler ◽  
Anjali Thota ◽  
Megan Branda ◽  
Rachel Giblon ◽  
...  

PurposeTo pilot test the impact of the ICAN Discussion Aid on clinical encounters.MethodsA pre–post study involving 11 clinicians and 100 patients was conducted at two primary care clinics within a single health system in the Midwest. The study examined clinicians’ perceptions about ICAN feasibility, patients’ and clinicians’ perceptions about encounter success, videographic differences in encounter topics, and medication adherence 6 months after an ICAN encounter.Results39/40 control encounters and 45/60 ICAN encounters yielded usable data. Clinicians reported ICAN use was feasible. In ICAN encounters, patients discussed diet, being active and taking medications more. Clinicians scored themselves poorer regarding visit success than their patients scored them; this effect was more pronounced in ICAN encounters. ICAN did not improve 6-month medication adherence or lengthen visits.ConclusionThis pilot study suggests that using ICAN in primary care is feasible, efficient and capable of modifying conversations. With lessons learned in this pilot, we are conducting a randomised trial of ICAN versus usual care in diverse clinical settings.Trial registration numberNCT02390570.


2021 ◽  
pp. 000348942110619
Author(s):  
Michal Plocienniczak ◽  
Batsheva R. Rubin ◽  
Alekha Kolli ◽  
Jessica Levi ◽  
Lauren Tracy

Objective: There is evidence to suggest adverse outcomes on patients’ medical and surgical care when there is language discordance in patient-physician relationships. No studies have evaluated the impact of limited English proficiency (LEP) on complications after common surgical procedures in otolaryngology. Furthermore, no studies have evaluated how patients with LEP utilize remote resources to connect with otolaryngology providers to better triage such complications. The purpose was to evaluate the incidence of post-tonsillectomy hemorrhage (PTH) comparing patients with LEP to those with English proficiency (EP). Patients with PTH were retrospectively evaluated to identify preceding telephone encounters, a marker of resource utilization. Methods: Demographics, English proficiency, and PTH management (surgical vs non-surgical) were evaluated in addition to PTH-associated triage telephone encounters with otolaryngology providers. Results: Of 2466 tonsillectomies, there were 141 episodes of reported hemorrhage (50 LEP vs 91 EP) in the 5 years studied. Rates were not significantly different between LEP and EP patients (4.9% vs 6.3%, P = .127). There was no statistically significant difference in rate of preceding telephone encounters between LEP and EP patients (24% vs 40%, P = .062). Of patients presenting directly to the Emergency Department without a triage telephone encounter, there was no difference in operative versus non-operative management when comparing LEP versus EP patients. However, patients presenting directly to the Emergency Department were nearly twice as likely to undergo operative intervention compared to patients with preceding telephone encounters (RR = 1.79). Conclusion: Patients with limited English proficiency are not at increased risk for developing PTH. There is equitable access to remote otolaryngologic triage care, although overall the utilization rate of this resource was low for both cohorts.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S27-S27
Author(s):  
Eloho Ajayi ◽  
Atsoufui kpehor ◽  
Shristi Khanal ◽  
Samavia Munir ◽  
Adrian Estepa

Abstract Background Influenza has been recognized to be a significant cause of morbidity and mortality. It was the cause of 10.1% of all deaths recorded on death certificates during the week ending January 20, 2018.In order to reduce the risk of influenza, Centers for Disease Control recommends that every person six months and older who have no contraindications be vaccinated with the influenza vaccine. Limited English Proficiency (LEP) describes individuals who have limited ability to speak, read, write or understand English language. Sadly, there is an increasing body of data that suggest that patients with LEP are less likely to seek out medical attention in a timely manner, are less adherent to medically recommended preventive and therapeutic measures. The purpose of this study was to determine the rate of acceptance of the Influenza vaccine amongst patients with LEP in our resident ran out-patient clinic. Methods This study was retrospective, data was obtained through chart review of the electronical medical records (EMR). Patients had to be at least 18 years old and registered patients at our primary health care clinic to be enrolled in this study. Data was gathered for the 2015–2016, 2016–2017 and 2017–2018 influenza seasons. The months of October to May were designated as the Influenza season as these months have been identified as the time frame that the influenza virus has the most activity. Results 109 of 499 the randomly selected participants were not included in the final analysis due to reasons like: no visit to the primary health care clinic during specified periods, ability to communicate in English, insufficient data in to the EMR. Data from 390 patients were analyzed. 43.3% spoke Spanish, 36.2% were Portuguese speaking and 20.5% spoke other languages. A large majority of patients across all language groups did not receive the influenza vaccine each season. Table 1 Figure 1 Figure 2 Conclusion Results from this study indicate that there was an alarmingly low rate of influenza vaccination among patients with LEP in our primary care clinic in during the 2015–2016, 2016–2017 and 2017–2018 influenza seasons. This highlights the need for implementing interventions aimed at both understanding why this vaccination gap exist and improving the vaccine acceptance rate amongst this venerable population. Disclosures All Authors: No reported disclosures


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