Limited English Proficiency in Older Adults Referred to the Cardiovascular Team

Medrano, F.J.; Fernández, Alicia; Sudore, Rebecca L.; Kirkpatrick, James N.; Benda, Natalie C.; Creber, Ruth Masterson; Goyal, Parag; Beavers, Craig J.; Maurer, Mathew S.; Rich, Michael W.; Alexander, Karen P.; Krishnaswami, Ashok

doi:10.1016/j.amjmed.2023.01.028

Cited by 5 publications

(10 citation statements)

References 23 publications

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“…HS attendance was significantly lower among foreign-born compared with native-born patients. In English-speaking countries, previous studies have demonstrated that preventive services such as vaccination, disease screening, Pap tests, mammograms and physician visits are underutilized among patients with LEP which is in accordance with our results (16–18). The underutilization of preventive services among LEP patients has been attributed to socioeconomic factors, cultural aspects, and language barriers.…”

Section: Discussionsupporting

confidence: 93%

“…To the best of our knowledge, the association between provision of professional interpreters and attendance to core components of CR (associated with attainment of secondary prevention goals) post-MI has not been studied previously. However, in a wide range of patient populations, the provision of professional interpreters improved outcomes by reducing unnecessary interventions in obstetric patients, lowering the rate of readmissions, and reducing the length of hospital stay in internal medicine patients (18, 21–23). Analogous to MI patients, in a previous study on LEP patients with diabetes and poor glycemic control, switching to a language-concordant physician to bridge the language barriers showed significant improvement both in glycemic control and LDL-cholesterol levels.…”

Section: Discussionmentioning

confidence: 99%

“…In Denmark, CR core components were provided to a lesser degree to non-Danish speaking patients without improvement over time (19,20). The use of professional interpreters has been suggested to bridge language barriers and improve outcomes in a wide range of patient populations (18,(21)(22)(23)(24). To our knowledge, the use of professional interpreters has not been studied in MI patients and no previous study has assessed the association between provision of professional interpreters and attendance to important CR elements in post-MI patients with limited majority language proficiency (the language predominantly spoken by healthcare professionals in the healthcare system that the patients attend).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, language has become an increasingly important healthcare barrier. Previous studies from United States and Canada have shown that patients with limited English proficiency (LEP) had fewer physician visits and were less likely to receive preventive services (16)(17)(18). In Denmark, CR core components were provided to a lesser degree to non-Danish speaking patients without improvement over time (19,20).…”

Section: Introductionmentioning

confidence: 99%

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Provision of professional interpreters and Heart School attendance for foreign-born compared with native-born myocardial infarction patients in Sweden

Zwackman,

Leosdottir,

Hagström

et al. 2023

Preprint

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Background and aimsInteractive patient education, referred to as Heart School (HS), is an important part of cardiac rehabilitation (CR) after myocardial infarction (MI), which has been associated with improved outcomes. Little is known about HS attendance among foreign-born patients. The aims were to assess; 1) HS attendance in foreign-born versus native-born patients, 2) the association between the provision of professional interpreters and HS attendance, and 3) secondary prevention goal attainment after MI based on HS attendance.MethodsThe provision of professional interpreters during post-MI follow-up was assessed by a questionnaire sent to all 78 Swedish CR sites. Patient-specific data was retrieved from the SWEDEHEART registry. The association between provision of professional interpreters and HS attendance was estimated with logistic regression models. HS attendance and attainment of secondary prevention goals by country of birth were investigated.ResultsIn total, 8377 patients <75 years (78% male) were included. Foreign-born (19.8%) had higher prevalence of cardiovascular risk factors and were less likely to attend HS (33.7 vs 51.3%, p<0.001), adjusted odds ratio (OR) 0.59 (95% confidence interval (CI) 0.52-0.68), compared with native-born patients. CR centers providing professional interpreters had higher HS attendance among foreign-born (adjusted OR 1.55, 95% CI 1.20-2.01) but not among native-born patients. Attending HS was similarly associated with improved secondary prevention goal attainment in both groups.ConclusionDespite similar positive association between HS attendance and attainment of secondary prevention goals, foreign-born patients attended HS less often. With provision of professional interpreters HS attendance appears to increase in foreign-born patients.

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Section: Discussionsupporting

confidence: 93%