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.

METHOD

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.

CONCLUSION

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.