Distress Screening Completion Less Likely Among Limited English Proficiency Patients

Patients with some level of limited English proficiency (LEP) were less likely to complete distress screening questionnaires compared with English-speaking patients, according to data from the 2021 ASCO Quality Care Symposium.

“Distress has a significant impact on the quality of life for patients with cancer, however implementation of screening for distress remains variable,” study researchers wrote in their poster. “There is limited data in this area for patients who have LEP.”

The researchers assessed 181,105 complete and incomplete distress screening questionnaires from the Stanford Cancer Center. For the study, LEP was defined as a patient’s electronic health record (EHR) demographic listing either a non-English preferred language or a request for an interpreter. Fourteen percent of questionnaires fit these criteria.

The overall screening completion rate was 57%. Completion was 62% for English-speaking patients and 49% for LEP patients (P < 0.001).

Completion rates were higher for telemedicine visits compared with in-person visits (62% vs. 51%). Among English-speaking patients’ completion was 78.9% for telemedicine visits and 55% for in-person visits (P < 0.001). Among LEP patients, completion was 65.1% for telemedicine and 43.7% for in-person (P < 0.001).

The researchers also validated their findings in a subset chart review for LEP patients in thoracic and gastrointestinal oncology, which have the two highest percentages of LEP patients. In this group, there were 18 languages represented. In these clinical notes, 48.8% of notes had specific mention of professional interpreter use and 25.5% mentioned family member interpreting for the patients. There were higher rates of family members interpreting with telemedicine (35%) compared with in-person visits (21%; P=0.04).

According to the researchers, these results indicate a need for improved access to distress screening and subsequent supportive care in LEP patients.