Identifying Challenges for Patients With Heart Failure and Limited English Proficiency

In the United States, patients with heart failure (HF) and limited English proficiency (LEP) experience worse HF outcomes, according to Zara Latif and colleagues. They sought to elucidate the mechanisms of this relationship using qualitative interviews with interpreters to “identify gaps in care quality and ways to improve care delivery for LEP HF patients.” Their findings, presented at the American College of Cardiology 71st Annual Scientific Session & Expo, demonstrate the “challenges that LEP HF patients face and provide potential solutions to improve care,” they wrote.

The study included semi-structured interviews with 20 interpreters from nine languages who were working at a tertiary academic medical center. The interviews focused on the interpreter’s perceptions of the challenges faced by LEP HF patients during care and what opportunities for improvement they saw.

Based on their interviews, the investigators identified three themes among the described challenges in care delivery: limited understanding of etiology, symptoms, and prognosis among LEP patients; difficulty for interpreters explaining HF “given the complexity of the topic;” and a lack of consensus on effective discharge processes for patients with LEP. Nineteen out of the 20 surveyed interpreters suggested a pre-encounter huddle would help address these challenges in care delivery, and supplied strategies for improving discharge including: having a family member present; providing a one-sentence summary of the patient’s condition to interpreters before issuing discharge instructions; giving nutrition referrals to help align diet instructions with patients’ native cuisines; and including contact information for interpreter services on discharge paperwork to help patients communicate with providers.

Ultimately, the authors presented their findings as a foundation for understanding and improving the care experience of patients with HF who have LEP. In closing, they suggested that “future studies focusing on integrating interpreters in the HF team and designing practical discharge plans for LEP HF patients could reduce current disparities.”