Impact of Interpreters on the Receipt of New Prescription Medication Information Among Spanish-Speaking Latinos

Robert Wood Johnson Clinical Scholars Program, University of California Los Angeles, Los Angeles, CA 90095, USA.
Medical care (Impact Factor: 3.23). 09/2009; 47(12):1201-8. DOI: 10.1097/MLR.0b013e3181adcc1b
Source: PubMed


For Latinos, limited English proficiency (LEP) is a barrier to receiving important information about a new medication prescription. Access to interpreters may impact the receipt of important medication-related information.
To examine the association between interpreter use and reports of new prescription medication advice among Latinos with LEP.
We examined cross-sectional survey data from 1590 Latino adults with LEP from 8 sites across the United States. The main outcomes are 5 measures of new prescription medication advising: (1) explanation of medication purpose, (2) explanation of possible side effects, (3) explanation of medication directions, (4) receipt of written information in Spanish from pharmacy, and (5) receipt of medicine bottle with Spanish language label.
Among patients prescribed a new medication, 72% reported being told about the purpose of the medication, 52% about possible side effects, and 70% about how to take the new medicine. Forty-four percent said they received written medication information in Spanish from pharmacy, and 47% said their medicine bottle label was written in Spanish. Interpreter use was independently associated with receiving explanations about: possible side effects (adjusted odds ratio [AOR] = 1.81; 95% confidence intervals [CI]: 1.16-2.45); medication directions (AOR = 2.50; 95% CI: 1.67-3.59); and medication purpose (AOR = 3.55; 95% CI: 2.14-4.65).
Among Latinos with LEP, interpreter use increases patient receipt of important information when a new medication is prescribed. There is a continuing need for effective policies and interventions to improve provider communication with LEP patients.

Download full-text


Available from: Gerardo Moreno, Mar 04, 2014
  • Source
    • "For this study, an a priori decision was made to not profile or rank individual study sites, but rather to focus on patient reports of care with respect to communication and satisfaction with care. We used studies in the literature to guide our selection of covariates and model factors that influence provider communication and patient satisfaction with care12,17,22,23,25. Using the imputed dataset, we conducted three multiple variable linear regression models to estimate the impact of interpreters on our three outcome measures while adjusting for survey year and clustering26 at the site of care [intraclass correlation coefficient (ICC) =0.020–0.026]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Hablamos Juntos-Together We Speak (HJ)--national demonstration project targeted the improvement of language access for Spanish-speaking Latinos in areas with rapidly growing Latino populations. The objective of HJ was to improve doctor-patient communication by increasing access to and quality of interpreter services for Spanish-speaking patients. To investigate how access to interpreters for adult Spanish-speaking Latinos is associated with ratings of doctor/office staff communication and satisfaction with care. Cross-sectional cohort study. A total of 1,590 Spanish-speaking Latino adults from eight sites across the United States who participated in the outpatient HJ evaluation. We analyzed two multi-item measures of doctor communication (4 items) and office staff helpfulness (2 items), and one global item of satisfaction with care by interpreter use. We performed regression analyses to control for patient sociodemographic characteristics, survey year, and clustering at the site of care. Ninety-five percent of participants were born outside the US, 81% were females, and survey response rates ranged from 45% to 85% across sites. In this cohort of Spanish-speaking patients, those who needed and always used interpreters reported better experiences with care than their counterparts who needed but had interpreters unavailable. Patients who always used an interpreter had better adjusted ratings of doctor communication [effect size (ES = 0.51)], office staff helpfulness (ES = 0.37), and satisfaction with care (ES = 0.37) than patients who needed but did not always use an interpreter. Patients who needed and always used interpreters also reported better experiences with care in all three domains measured [doctor communication (ES = 0.30), office staff helpfulness (ES = 0.21), and satisfaction with care (ES = 0.23)] than patients who did not need interpreters. Among adult Spanish-speaking Latinos, interpreter use is independently associated with higher satisfaction with doctor communication, office staff helpfulness, and ambulatory care. Increased attention to the need for effective interpreter services is warranted in areas with rapidly growing Spanish-speaking populations.
    Full-text · Article · Dec 2010 · Journal of General Internal Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Language concordance between physicians and patients may reduce barriers to care faced by patients with limited English proficiency (LEP). It is unclear whether physicians with fluency in non-English languages practice in areas with high concentrations of people with LEP. To investigate whether physician non-English language fluency is associated with practicing in areas with high concentrations of people with LEP. Cross-sectional cohort study. A total of 61,138 practicing physicians no longer in training who participated in the California Medical Board Physician Licensure Survey from 2001-2007. Self-reported language fluency in Spanish and Asian languages. Physician practice ZIP code corresponding to: (1) high concentration of people with LEP and (2) high concentration of linguistically isolated households. Practice location ZIP code was geocoded with geographic medical service study designations. We examined the unadjusted relationships between physician self-reported fluency in Spanish and selected Asian languages and practice location, stratified by race-ethnicity. We used staged logistic multiple variable regression models to isolate the effect of self-reported language fluency on practice location controlling for age, gender, race-ethnicity, medical specialty, and international medical graduate status. Physicians with self-reported fluency in Spanish or an Asian language were more likely to practice in linguistically designated areas in these respective languages compared to those without fluency. Physician fluency in an Asian language [adjusted odds ratio (AOR) = 1.77; 95% confidence intervals (CI): 1.63-1.92] was independently associated with practicing in areas with a high number of LEP Asian speakers. A similar pattern was found for Spanish language fluency (AOR = 1.77; 95% CI: 1.43-1.82) and areas with high numbers of LEP Spanish-speakers. Latino and Asian race-ethnicity had the strongest effect on corresponding practice location, and this association was attenuated by language fluency. Physicians who are fluent in Spanish or an Asian language are more likely to practice in geographic areas where their potential patients speak the corresponding language.
    Full-text · Article · Dec 2010 · Journal of General Internal Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: The value of qualified language interpretation services for limited-English-proficient patients is gaining increasing recognition by policy makers and researchers in the United States. Yet the actual work experiences of health care interpreters have not been adequately studied. The purpose of this qualitative research was to explore the work experiences of formal and informal interpreters (n = 27). The core narrative finding from the interview data was the complex, challenging, exhausting, and often invisible work of language interpretation. Critical examination of health care interpreters' complex work and interactions with patients, providers, and administrators is needed to provide more effective and integrated services for limited-English proficient patients.
    No preview · Article · Feb 2011 · Journal of Transcultural Nursing
Show more