Fátima Rodríguez|Christine Hong|Yuchiao Chang|Lynn B. Oertel|Daniel E. Singer|Alexander R. Green|Lenny López
Limited English Proficient Patients and Time Spent in Therapeutic Range in a Warfarin Anticoagulation Clinic
Brigham and Women's Hospital|Harvard University|Harvard University|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Massachusetts General Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|Massachusetts General Hospital|MGH Institute of Health Professions
anticoagulation clinics shown deliver tailored highquality care patients receiving warfarin therapy communication barriers limited english proficient lep patients may lead disparities anticoagulation outcomeswe analyzed data 3770 patients receiving care massachusetts general hospital anticoagulation management service ams 2009 2010 included data international normalized ratio inr tests patient characteristics including language whether ams used surrogate primary communication calculated percent time therapeutic range ttr inr 20 30 time danger range tdr inr 18 35 using standard rosendaal interpolation method 241 lep patients lep patients compared nonlep patients higher number comorbidities 32 versus 29 comorbidities p0004 frequently uninsured 170 versus 43 p0001 less educated 477 versus 60 high school education p0001 lep patients compared nonlep patients spent less ttr 716 versus 740 p0007 tdr 129 versus 113 p0018 adjusted analyses lep patients lower ttr compared nonlep patients 15 95 ci 11 22 lep patients used communication surrogate spent less ttr tdreven within large anticoagulation clinic high average ttr small significant decrease ttr observed lep patients compared english speakers future studies warranted explore use professional interpreters impact ttr lep patients