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Asthma outcomes worse for elderly patients lacking English proficiency

Limited English proficiency was associated with poorer self-management and worse outcomes among elderly patients with asthma, according to a recent study.

Researchers conducted a prospective study that included 268 elderly individuals aged 60 or older with asthma from three inner-city outpatient clinics in New York and Chicago. Participants were non-Hispanic (68%), English-proficient Hispanic (18%), and Hispanic with limited English proficiency (14%). In the 21-month study, investigators conducted English or Spanish interviews in clinic offices at baseline and at 3 months. The Asthma Control Questionnaire (ACQ) and the Mini-Asthma Quality of Life Questionnaire (AQLQ) were used to assess patients.

Unadjusted results indicated that Hispanic patients with limited English proficiency had worse asthma control (mean difference in ACQ score=0.81; 95% CI, 0.40-1.23), an increased likelihood of exacerbations requiring inpatient treatment (OR=3.5; 95% CI, 1.6-7.7), and poorer medication adherence (OR=0.30; 95% CI, 0.14-0.65) compared with non-Hispanic patients. The Hispanics with limited English proficiency also demonstrated poorer quality of life (mean difference in AQLQ score= –1.3; 95% CI, –1.7 to –0.86).

After adjusting for demographics, asthma history, comorbidities, depression, and health literacy, researchers found that ACQ scores were not significant between the groups (P=.56). AQLQ scores, however, indicated a poorer quality of life for Hispanics with limited English compared with non-Hispanics (mean difference= –0.67; 95% CI, –1.14 to –0.20).

“This prospective study of elderly patients with asthma demonstrates several associations between limited English proficiency and increased asthma morbidity,” the researchers wrote. “Further research is needed to understand the underlying mechanism for these effects of limited English proficiency if health outcomes are to be optimized for elderly inner-city patients.”