Caring For Patients With HF and Limited English Proficiency: the Interpreter’s Perspective

A study using semistructured interviews of interpreters working at a tertiary academic medical center found that patients with limited English proficiency (LEP) who present with heart failure (HF) had unique needs that should be considered at the time of discharge, according to research presented at the American College of Cardiology 71st Annual Scientific Session and Expo, from April 2nd through 4th, in Washington, DC.

Patients living in the United States with HF who have LEP are associated with poorer clinical outcomes overall. In order to interrogate potential causes of disparities in outcomes, investigators at Harvard Medical School conducted semistructured interviews with 20 interpreters working at their center.

The interpreters were able to speak 9 different languages total.

Three major themes were observed in this study. Patients with HF and LEP in general had limited understanding of their HF prognosis, etiology, and symptoms. The interpreters expressed that they had difficulty when they tried to explain the complexity of HF. The interpreters were concerned about the lack of consensus regarding what discharge process measures were effective for this patient population.

All but 1 interpreter suggested that a pre-encounter huddle among the HF care team may allow for more effective delivery of care, in which the interpreters wished they received a 1-sentence summary about the patient’s condition before assisting with discharge instructions.

In addition, the interpreters suggested that inclusion of a family member at discharge, tailoring dietary information to fit with the patient’s culture, and providing contact information for interpreter services could be potential effective mitigation strategies for improving the discharge process.

This study was conducted at a single center and these findings may not be generalizable to other sites.

This study found that patients with HF who have LEP experience unique challenges, like the lack of understanding about their condition, which likely contributes to poorer clinical outcomes. “Future studies focusing on integrating interpreters in the HF team and designing practical discharge plans for LEP HF patients could reduce current disparities,” the researchers wrote.

Reference

Latif Z, Makuvire T, Feder SL, et al. Challenges facing heart failure patients with limited English proficiency: a qualitative analysis leveraging medical interpreters’ perspectives. Presented at: American College of Cardiology 71st Annual Scientific Session & Expo; April 2-4, 2022; Washington, DC