Journal of general internal medicine
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Comparative Study
Access to mental health treatment by English language proficiency and race/ethnicity.
Limited English proficiency (LEP) may contribute to mental health care disparities, yet empirical data are limited. ⋯ LEP is associated with lower use of mental health care. Since LEP is concentrated among Asian/PIs and Latinos, it appears to contribute to racial/ethnic disparities in mental health care. Heightened attention to LEP is warranted in both mental health practice and policy.
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Comparative Study
Race/ethnicity and nonadherence to prescription medications among seniors: results of a national study.
Nonadherence to prescription drugs results in poorer control of chronic health conditions. Because of significant racial/ethnic disparities in the control of many chronic diseases, differences in the rates of and reasons for medication nonadherence should be studied. ⋯ Racial/ethnic disparities in medication nonadherence exist among seniors, and are related to cost concerns, and not to differences in experiences or self-assessed need. Considering the importance of medication adherence in controlling chronic diseases, affordability of prescriptions should be explicitly addressed to reduce racial/ethnic disparities.
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Exacerbations are important disease events for patients with chronic obstructive pulmonary disease (COPD) as they are relatively frequent, result in significant resource use and can indicate worsening disease. Little is known about variation in COPD exacerbation rates across a health system in various geographic regions. ⋯ Geographic variation in the VA VISN system supports evidence that the medical care system including provider factors, and less so patient factors, affect COPD exacerbations. Understanding the reasons underlying this variation in COPD exacerbation rates may lead to improvements in future care and outcomes.
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Randomized Controlled Trial
Is information on genetic determinants of obesity helpful or harmful for obese people?--A randomized clinical trial.
Although more and more genetic information is available, it is unclear whether this information is helpful for patients. Therefore, we assessed the positive and negative effects of informing obese people about the genetic etiology of being overweight. ⋯ Consultations in obesity can be helpful in general. These consultations should include genetic information if people have a family history of obesity.
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Comparative Study
Assessing dual-role staff-interpreter linguistic competency in an integrated healthcare system.
Interpreter services for medical care increase physician-patient communication and safety, yet a "formal certification" process to demonstrate interpreter competence does not exist. Testing and training is left to individual health care facilities nationwide. Bilingual staff are often used to interpret, without any assessment of their skills. Assessing interpreters' linguistic competence and setting standards for testing is a priority. ⋯ We found that about 1 in 5 dual-role staff interpreters at a large health care organization had insufficient bilingual skills to serve as interpreters in a medical encounter. Health care organizations that depend on dual-role staff interpreters should consider assessing staff English and second language skills.