Non-English Speaking Liver Disease Patients with Translators Have Similar Adherence to Recommendations as English-Speaking Liver Disease Patients

Abstract

Purpose: Language barriers can present increased difficulties in providing quality care for non-English speaking patients. Translators are often used in clinical settings to improve physician-patient communication and adherence to recommendations. Treatment regimens can be difficult for liver disease patients; however, it is unclear what effect differences in physician-patient language can have on compliance. This study evaluated whether non-English speaking liver disease patients with translators have similar compliance with recommendations as English-speaking liver disease patients who do not require translator assistance. Methods: The medical records of consecutive non-English speaking liver disease patients with documented translator-assistance and English speaking liver patients who were referred to an urban university gastroenterology practice in a one-year period were reviewed. Patient age, gender, diagnosis, primary language, recommendations, adherence to recommendations and utilization of a translator were obtained. A database was created using Microsoft Excel. Statistical analysis was performed using Fisher's Exact test with significance set at p<0.05. The study was approved by the IRB. Results: 31 medical records of consecutive non-English speaking liver disease patients with documented translator assistance were reviewed. There were 17 men and 14 women, with a mean age of 53.5 years. The primary languages were Spanish (45.2%), Arabic (29%) and Anharic (22%). 30 medical records of English speaking liver disease patients were reviewed. There were 15 men and 15 women, with a mean age of 52.9 years. Liver disease included transaminitis, nonalcoholic steatohepatitis, viral hepatitis, cirrhosis and hepatocellular carcinoma. 28 (90.3%) of non-English speaking patients had documented adherence to physician recommendations. 30 (100%) of English-speaking patients had documented adherence to physician recommendations. There was no statistically significant difference (p=0.238) in the rate at which non-English speaking patients adhered to recommendations compared to English speaking patients. Conclusion: Liver disease can require multifaceted management. Adherence to recommendations is an important component of health care. This study revealed that non-English speaking liver disease patients with translators had excellent and similar adherence to recommendations as English-speaking liver disease patients. Translators appeared to support patients' ability to manage their liver disease. Optimum care is achieved when physicians make efforts to ensure that translation of medical recommendations for non-English speaking patients occurs.