Patient‐Reported Outcomes in Rheumatology Patients With Limited English Proficiency and Limited Health Literacy

Bedoya, Guiset Carvajal; Davis, Lisa; Hirsh, Joel M.

doi:10.1002/acr.24243

Cited by 5 publications

(4 citation statements)

References 74 publications

(76 reference statements)

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“…Specifically, patients who did not speak English as a primary language exhibited significantly worse hearing and therefore worse HRQoL than English‐speaking patients with hearing loss. These results are consistent with a growing body of evidence that links language barriers to worse health outcomes 28‐31 . One study found that language barriers are associated with unequal access to care and poorer health outcomes 28 .…”

Section: Discussionsupporting

confidence: 85%

“…These results are consistent with a growing body of evidence that links language barriers to worse health outcomes. 28 , 29 , 30 , 31 One study found that language barriers are associated with unequal access to care and poorer health outcomes. 28 Even when care is available, health care providers view language barriers as a source of workplace stress that impedes their ability to provide high‐quality care.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Language, Age, and Hearing Loss on Health‐Related Quality of Life

et al. 2023

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Objective To understand the effect of age on health‐related quality of life (HRQoL) in patients with hearing loss and determine how primary language mediates this relationship. Study Design Cross‐sectional study. Setting General otolaryngology clinic in Los Angeles. Methods Demographics, medical records, and HRQoL data of adult patients presenting with otology symptoms were reviewed. HRQoL was measured using the Short‐Form 6‐Dimension utility index. All patients underwent audiological testing. A path analysis was performed to generate a moderated path analysis with HRQoL as the primary outcome. Results This study included 255 patients (mean age = 54 years; 55% female; 27.8% did not speak English as a primary language). Age had a positive direct association with HRQoL (p < .001). However, the direction of this association was reversed by hearing loss. Older patients exhibited significantly worse hearing (p < .001), which was negatively associated with HRQoL (p < .05). Primary language moderated the relationship between age and hearing loss. Specifically, patients who did not speak English as a primary language had significantly worse hearing (p < .001) and therefore worse HRQoL (p < .01) than patients who spoke English as a primary language with hearing loss. Increasing age was associated with bilateral hearing loss compared to unilateral hearing loss (p < .001) and subsequently lower HRQoL (p < .001). Polypharmacy (p < .01) and female gender (p < .01) were significantly associated with lower HRQoL. Conclusion Among otolaryngology patients with otology symptoms, older age and not speaking English as a primary language were associated with worse hearing and subsequently lower HRQoL.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Effects of Language, Age, and Hearing Loss on Health‐Related Quality of Life

et al. 2023

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“…Patient-reported outcome measures (PROMs) are a set of widely available tools that directly capturePROs. PROMs are increasingly being used in clinical rheumatology practice and in research to help inform patient-centered care and clinical decision-making even among vulnerable rheumatic disease (RD) patients such as those with low health literacy or English proficiency [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Patient-reported outcome measure of the quality of life in Ugandans living with autoimmune rheumatic diseases

Bongomin

Sekimpi

Natukunda

et al. 2021

The Egyptian Rheumatologist

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“…Patient-reported outcome measures (PROMs), are a set of widely available tools directly capture PROs and are increasingly being used in clinical rheumatology practice and in research to help inform patient-centered care and clinical decision-making even among vulnerable rheumatic patients such as those with low health literacy or English proficiency. 6…”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Outcomes of Ugandans Living with Autoimmune Rheumatic Diseases

Bongomin

Sekimpi

Natukunda

et al. 2021

Preprint

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PurposeThis study aimed to assess the patient–reported outcomes (PROs) in rheumatic patients attending two tertiary rheumatology clinics in Uganda.MethodsA cross-sectional, clinical audit of patients aged 16 years or older with a confirmed diagnosis of rheumatic disease and receiving disease modifying anti-rheumatic drugs (DMARDs) was conducted between September and December 2020. Health index and overall self-rated health status were assessed using the ED-5D-5L tool. Comparisons for variables was performed using Student’s t-test or Mann-Whitney U for continuous numerical data while categorical data was compared using either Χ2 tests or Fisher’s exact tests as appropriate.ResultsWe enrolled 74 eligible patients: 48 (64.9%) had rheumatoid arthritis (RA), 14 (18.9%) had systemic lupus erythematosus (SLE), and 12 (16.2%) had other autoimmune rheumatic disorders. Majority (n=69, 93.2%) were female with a mean ±SD age of 45 ± 17 years. Fourteen (18.9%) patients were on concomitant herbal medication while using DMARDs and 26 (35.1%) self-reported at least 1 adverse drug reactions to the DMARDS. Any level of problem was reported by 54 (72.5%) participants for mobility, 47 (63.5%) for self-care, 56 (75.6%) for usual activity, 66 (89.1%) for pain and discomfort, and 56 (75.6%) for anxiety/depression. Patients with SLE had higher median health index compared to those other autoimmune rheumatic disorders (p<0.0001). Overall self-rated health status was comparable across clinical diagnoses (p=0.2), but better for patients who received care from private (Nsambya Hospital) compared to public hospital (Mulago Hospital) (65 vs. 50, p=0.009).ConclusionThere is a substantial negative impact of autoimmune rheumatic diseases on quality of life of patients, especially those receiving care from a public facility in Uganda.Clinical SignificanceAdverse drug reactions to DMARDs was reported by more than one-third of the patientsSLE patients have better quality of life compared to patients with other autoimmune rheumatic disease.Concomitant use of herbal medication is common and associated with lower health index and lower overall self-rated health status.Autoimmune rheumatic diseases impose a heavy financial burden on affected patients, over 70% of the study patients required financial support for management of their disease and a high proportion of these patients were not on their DMARD therapy the week prior to their scheduled clinic appoints.

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Patient‐Reported Outcomes in Rheumatology Patients With Limited English Proficiency and Limited Health Literacy

Cited by 5 publications

References 74 publications

Effects of Language, Age, and Hearing Loss on Health‐Related Quality of Life

Effects of Language, Age, and Hearing Loss on Health‐Related Quality of Life

Patient-reported outcome measure of the quality of life in Ugandans living with autoimmune rheumatic diseases

Patient-Reported Outcomes of Ugandans Living with Autoimmune Rheumatic Diseases

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