Sahyoun Laura C, Chavez Veronica, Vasudevan Jaya, Kogan Lawrence, Mukkamala Bhuvana, Ochi Maria Goretti, Anand Thritha, Ahmed Zehra, Tang Zhouwen, Feagins Linda A, Gaidos Jill K J
Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York, USA.
Division of Gastroenterology and Hepatology, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.
Clin Transl Gastroenterol. 2025 Jun 6;16(8):e00868. doi: 10.14309/ctg.0000000000000868. eCollection 2025 Aug 1.
As rates of inflammatory bowel disease (IBD) rise among non-English-speaking populations, it is imperative to better understand the impact of language barriers and cultural differences on disease management.
The multicenter, retrospective, cohort study of adult patients with IBD who spoke a language other than English, matched 1:2 to English-speaking controls. Patients were enrolled at their first clinic visit and then followed up to 12 months. Advanced therapy (AT) was defined as a biologic or small molecule. Primary outcome was the rate of AT use between cohorts. Secondary outcomes included rates of AT initiation and corticosteroid-free clinical remission at 6 and 12 months.
One hundred forty-four patients with IBD (48 non-English speakers, 96 English speakers) were included in this study. Both cohorts had similar baseline disease activity based on physician global assessment; however, non-English-speaking patients had significantly higher rates of baseline elevated fecal calprotectin (91.7% vs 50%, P = 0.014). After multivariate analysis to adjust for baseline differences, we found no difference in prior or current AT use. Rates of initiation of AT were similar between the 2 groups at 6- and 12-month follow-up. Adjusted rates of corticosteroid-free clinical remission were not different at 6 and 12 months.
Primary language spoken did not significantly affect the rates of AT use or overall IBD disease activity in 2 academic practices. Future studies are warranted to understand the effect of language on medication adherence, patient satisfaction and understanding, and disease outcomes.
随着非英语人群中炎症性肠病（IBD）发病率的上升，更好地了解语言障碍和文化差异对疾病管理的影响至关重要。
对成年IBD患者进行多中心、回顾性队列研究，这些患者说英语以外的语言，按1:2与说英语的对照组匹配。患者在首次门诊就诊时入组，随后随访12个月。高级治疗（AT）定义为生物制剂或小分子药物。主要结局是队列之间AT的使用比例。次要结局包括6个月和12个月时AT启动率以及无皮质类固醇临床缓解率。
本研究纳入了144例IBD患者（48例非英语使用者，96例英语使用者）。根据医生整体评估，两组患者的基线疾病活动度相似；然而，非英语使用者的基线粪便钙卫蛋白升高率显著更高（91.7%对50%，P = 0.014）。在进行多变量分析以调整基线差异后，我们发现既往或当前AT使用情况没有差异。在6个月和12个月的随访中，两组AT启动率相似。6个月和12个月时无皮质类固醇临床缓解的调整率没有差异。
在两种学术实践中，主要使用的语言并未显著影响AT的使用比例或IBD总体疾病活动度。有必要开展进一步研究以了解语言对药物依从性、患者满意度和理解以及疾病结局的影响。
