The Influence of Patient-Provider Language Concordance in Cancer Care: Results of the Hispanic Outcomes by Language Approach (HOLA) Randomized Trial

Abstract results

Each result the abstract reports — is it captured as evidence?

• Compared with patients receiving care through professional interpretive services, patients cared for in direct Spanish reported significantly improved general satisfaction, technical quality of care (mean composite score [MCS], 4.41 vs 4.06; P = .005), care team interpersonal manner (MCS, 4.37 vs 3.88; P = .004), communication (MCS, 4.50 vs 4.25; P = .018), and time spent with patient,(MCS, 4.30 vs 3.92; P = .028).

  suggested · 37% Beyond the primary endpoint, several secondary overall-care satisfaction domains measured immediately after the initial consultati

  Covered Promote Not a result

• Specific to physician communication, patients rated direct-Spanish care more highly in perceived opportunity to disclose concerns (MCS 4.91 vs 4.62; P = .001), physician empathy (MCS, 4.94 vs 4.59; P <.001), confidence in physician abilities (MCS, 4.84 vs 4.51; P = .001), and general satisfaction with their physician (MCS, 4.88 vs 4.59; P <.001).

  suggested · 39% On the physician-communication satisfaction survey (ISQ) administered immediately after the initial consultation, the direct-Spani

  Covered Promote Not a result

• Analyzing the content of consultation encounters revealed differences between study arms, with the direct-Spanish arm having more physician speech related to patient history verification (mean number of utterances, 13 vs 9; P = .01) and partnering activities (mean utterances, 16 vs 5; P <.001).

  suggested · 31% Coded transcripts of the initial consultation showed that, relative to interpreter-based encounters, direct-Spanish encounters had

  Covered Promote Not a result

• Additionally, patients in the direct-Spanish arm were more likely to initiate unprompted speech (mean utterances, 11 vs 3; P <.001) and asked their providers more questions (mean utterances, 11 vs 4; P = .007).

  suggested · 26% Coded consultation transcripts showed patients in the direct-Spanish arm were more verbally engaged than those in the interpreter-

  Covered Promote Not a result

• This study shows improved patient-reported satisfaction among patients with cancer who had LEP and were cared for in direct Spanish compared with interpreter-based communication.

  Covered Promote Not a result

• Further research into interventions to mitigate the patient-provider language barrier is necessary to optimize care for this population.

  Covered Promote Not a result

Tables & figures

Map each object to the evidence it grounds (one object can ground several), add anything missed, or flag a gap.

• Figure 1

  p4
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture
• 

  Figure 2

  p6
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture
• 

  Figure 3

  p7
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture

• Table 1

  p5
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture

• Table 2

  p8
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture
• 

  Table 3

  p8
  • Direct-Spanish care raised primary-endpoint general satisfaction over interpreter services (4.45 vs 4.09) in an RCT
  • Direct-Spanish care raised satisfaction with overall-care domains (technical quality, interpersonal manner, communication, time spent)
  • Direct-Spanish care raised satisfaction with physician communication (disclosure, empathy, confidence, general)
  • Direct-Spanish consultations had more physician history-verification and partnering utterances
  • Initial consultation length did not differ between direct-Spanish and interpreter-services arms (37 vs 33 min)
  • Patients in direct-Spanish consultations asked more questions and gave more unprompted speech
  • Satisfaction benefit of direct-Spanish care attenuated to nonsignificance at later treatment timepoints
  Add evidence Flag gap Nothing to capture