Association of Primary Language With Treatment and Outcomes in Inflammatory Bowel Disease.
Academic Article
Overview
abstract
INTRODUCTION: As rates of inflammatory bowel disease (IBD) rise among non-English-speaking populations, it is imperative to better understand the impact of language barriers and cultural differences on disease management. METHODS: The multicenter, retrospective, cohort study of adult patients with IBD who spoke a language other than English, matched 1:2 to English-speaking controls. Patients were enrolled at their first clinic visit and then followed up to 12 months. Advanced therapy (AT) was defined as a biologic or small molecule. Primary outcome was the rate of AT use between cohorts. Secondary outcomes included rates of AT initiation and corticosteroid-free clinical remission at 6 and 12 months. RESULTS: One hundred forty-four patients with IBD (48 non-English speakers, 96 English speakers) were included in this study. Both cohorts had similar baseline disease activity based on physician global assessment; however, non-English-speaking patients had significantly higher rates of baseline elevated fecal calprotectin (91.7% vs 50%, P = 0.014). After multivariate analysis to adjust for baseline differences, we found no difference in prior or current AT use. Rates of initiation of AT were similar between the 2 groups at 6- and 12-month follow-up. Adjusted rates of corticosteroid-free clinical remission were not different at 6 and 12 months. DISCUSSION: Primary language spoken did not significantly affect the rates of AT use or overall IBD disease activity in 2 academic practices. Future studies are warranted to understand the effect of language on medication adherence, patient satisfaction and understanding, and disease outcomes.
