Having a Spanish-Speaking Doctor Might Help Latino Patients Adhere to Diabetes Drugs

Latino patients who don’t speak English are less likely to stick with a diabetes drug regimen than white patients or Latinos who speak English, but having a doctor who speaks Spanish may improve adherence, a new study has found.

JAMA Internal Medicine reports results from a study of 1605 Latino patients with diabetes who changed primary care physicians between January 1, 2007, and December 31, 2013. All were enrolled in the Kaiser Permanente Northern California health system and preferred speaking Spanish. The study measured whether switching to a Spanish-speaking doctor led to improved glycemic control.

Researchers led by Melissa M. Parker, MS, found that when patients who had an English-speaking doctor switched to one who spoke Spanish, there was “a significant net improvement in glycemic and LDL [low-density lipoprotein cholesterol] control.” Prevalence of glycemic control increased 10%, and poor glycemic control fell 4%. Control of LDL cholesterol rose 9%. There were no significant changes in blood pressure.¹

What if patients switched from a doctor who spoke Spanish to one who didn’t? This study found a 15% increase in prevalence of LDL cholesterol control, but researchers suspect that was due to an unmeasured factor, such as increased trust in the primary care physician (PCP).

“Health systems caring for Latinos (with low English proficiency) with diabetes may also improve glycemic control by facilitating language-concordant care, even if it means switching PCPs,” the authors wrote.

In an accompanying editorial, Jennifer Alvidrez, PhD, and Eliseo J. Perez-Stable, MD, found that the results support educating more Spanish-speaking doctors, “so that all patients who need or prefer to communicate in Spanish can do so.”²

Unburdened of their limited English, these Latino patients “ask more questions, and report better communication with their clinicians when in concordant care, and the findings that glucose control is improved strengthen this recommendation.”

More challenging is the fact that medication adherence is comparatively poor across the Latino population. But the editorial writers find that giving patients a doctor who speaks their language does not do harm, and may do some good.

References

1. Parker MM, Fernandez A, Moffet HH, et al. Association of patient-physician language concordance and glycemic control for limited-English proficiency Latinos with type 2 diabetes [published online January 23, 2017]. JAMA Intern Med. 2017; doi:10.1001/jamainternmed.2016.8648.

2. Alvidrez J, Perez-Stable EJ. Diabetes care in Latinos with limited English proficiency: what do language concordant clinicians add? [published online January 23, 2017]. JAMA Intern Med. 2017; doi:10.1001/jamainternmed.2016.8661.