• Michael H Andreae, Robert S White, Kelly Yan Chen, Singh Nair, Charles Hall, and Naum Shaparin.
• Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
• Pain Med. 2017 Feb 1; 18 (2): 265274265-274.

UnlabelledLanguage barriers can prevent pain physicians and patients from forming meaningful rapport and drive health care disparities. Non-adherence with scheduled pain clinic appointments deprives patients with chronic pain of needed specialist care.ObjectiveWe evaluated the benefit of comprehensive initiatives to overcome language barriers to improve patient adherence with initial scheduled chronic pain clinic appointments.DesignAfter implementation of our initiative, we performed a retrospective cross-sectional analysis and fit logistic regression models to investigate the association between demographic factors and adherence.SettingWe collected retrospective data from an observational cohort with a scheduled appointment at the adult inner-city underserved outpatient Pain Center at Montefiore Medical Center, Bronx, New York.PatientsBetween March 2012 and March 2014, 14,459 appointments were scheduled; 3,035 of these appointments represented initial first visits; patients had a mean age of 53 years; 15% were predominantly Spanish-speaking, 65% were female.InterventionsOur initiative to overcome language barriers in our pain clinic included appointment reminders in the patient’s preferred language, Spanish-speaking staff, and unified locations with equitable access.Outcome MeasuresOur dependent variable was adherence with a first scheduled pain clinic appointment.ResultsWe found that after implementation of our initiative, speaking Spanish was now statistically significantly associated with higher rates of adherence with appointments (Odds Ratio 1.32, 95% confidence interval [1.06–1.64]).ConclusionsWe infer from our results that coordinated initiatives to overcome language barriers can be beneficial in improving appointment adherence and access to care by enhancing rapport and communication between pain physicians and their patients.PerspectiveThe results of this retrospective cross-sectional analysis of patients’ adherence with scheduled appointments in an inner-city chronic pain clinic suggests that targeted initiatives including a pre-clinic reminder phone call in the patient’s own language may help to overcome language barriers and improve access to care.

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