The association between language proficiency and outcomes of elderly patients with asthma.
BACKGROUND
Asthma is a growing cause of morbidity for elderly Americans and is highly prevalent among Hispanic people in the United States. The inability to speak English poses a barrier to patient-provider communication.


OBJECTIVE
To evaluate associations between limited English proficiency, asthma self-management, and outcomes in elderly Hispanic patients.


METHODS
Elderly patients with asthma receiving primary care at clinics in New York City and Chicago were studied.


RESULTS
Of 268 patients in the study, 68% were non-Hispanic, 18% English-proficient Hispanic, and 14% Hispanic with limited English proficiency. Unadjusted analyses showed that Hispanic persons with limited English proficiency had worse asthma control (P = .0007), increased likelihood of inpatient visits (P = .002), and poorer quality of life (P < .0001). We also found significant associations between limited English proficiency and poorer medication adherence (P = .006). Similar results were obtained in multiple regression analyses adjusting for demographics, asthma history, comorbidities, depression, and health literacy.


CONCLUSIONS
Limited English proficiency was associated with poorer self-management and worse outcomes among elderly patients with asthma. Further understanding of mechanisms underlying this relationship is necessary to develop interventions that improve asthma outcomes in this vulnerable population.
Division of General Internal Medicine, Mount Sinai School of Medicine, New York, New York, USA. Juan.Wisnivesky@mssm.edu
Juan P
JP
Wisnivesky
Katherine
K
Krauskopf
Michael S
MS
Wolf
Elizabeth A H
EA
Wilson
Anastasia
A
Sofianou
Melissa
M
Martynenko
Ethan A
EA
Halm
Howard
H
Leventhal
Alex D
AD
Federman
D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D002641:Chicago / Q000453:epidemiology; D003144:Communication Barriers; D032882:Comprehension; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011788:Quality of Life; D011795:Surveys and Questionnaires