Objective: This systematic review assessed whether physician–patient language concordance, compared with discordance, is associated with better health outcomes.Methods: A systematic literature search was conducted, without language restrictions, using PubMed, EMBASE, Web of Science, and PsycINFO, from inception to July 2020. We included studies that evaluated the effects of physician–patient language concordance on health outcomes. Articles were screened, selected, and data-extracted in duplicate. Review protocol was prospectively registered (PROSPERO, CRD42020157229).Results: There were 541 citations identified through databases and eight citations through reverse search and Google Scholar. A total of 15 articles (84,750 participants) were included reporting outcomes within five domains: diabetes care (four studies), inpatient care (five studies), cancer screening (three studies), healthcare counseling (two studies), and mental health care (one study). Ten studies were of good quality, four were fair, and one was poor, according to the modified Newcastle-Ottawa Scale. Eight studies (53%) showed a significant negative association between language discordance and at least one clinical outcome. Five studies (33%) found no association.Conclusion: Over half the evidence collated showed that physician–patient language concordance was associated with better health clinical outcomes.

Quality improvement project (QUIP) concepts are becoming embedded into medical school curricula, with many students now expected to conduct a QUIP as part of their progression. This study aimed to assess whether student-led QUIPs can be effective and sustainable. A systematic literature search was conducted using 5 databases: MEDLINE, Embase, Ovid, CINAHL, and PsycINFO. The authors searched for articles published between January 28, 1978, and January 28, 2018. In all, 3965 articles were identified through database searching, and an additional 9 articles through hand searches. After screening and full-text analysis, 12 articles were included. Greater than 50% of QUIPs described a statistically significant improvement in the primary outcome. However, effective student-led QUIPs were not necessarily sustainable, with a mean final audit at 4.4 months. Medical students have the potential to produce effective QUIPs. There now needs to be a structured approach to give medical students the freedom to test and validate more unique interventions.

Aims To review antiplatelet therapy of vascular patients who had undergone CEA post TIA over a 1-year period and to compare their antiplatelet therapy to European Society of Vascular Surgery (ESVS) guidelines for atherosclerotic carotid disease. Methods We reviewed all patients admitted under the vascular team who underwent elective CEA from 1/1/20 to 1/1/21 (n=65). We reviewed the antiplatelet therapy that were prescribed on discharge summaries, and compared to current ESVS guidance. According to ESVS guidance, it is stated that dual antiplatelet therapy (DAPT) is not recommended in patients undergoing carotid endarterectomy unless indicated for cardiac reasons. Results Out of the 65 patients who were discharged over one year, 55% were discharged on DAPT, with the remaining 45% prescribed either aspirin or clopidogrel alone. Additionally, there was heterogeneity in the treatment duration for antiplatelet therapy across patients. However, on 3 month follow up appointments, 100% of patients were advised to continue on SAPT long-term in accordance to guidance. Conclusions Given the heterogeneity in treatment plans for CEA patients over the studied time period, we believe there is value in introducing weekly teaching sessions for MDT members of all grades, to keep all members up to date on current guidance. Additionally, use of posters incorporating up to date antiplatelet therapy guidance may also serve as a useful tool for doctors discharging post CEA patients. Despite the heterogeneity noted on discharge summaries, 100% of patients were advised to continue on SAPT long term in follow up clinic appointments.

No abstract