Interpreting Services Bridge Language Gaps in Diabetic Retinopathy Care: A Retrospective Cohort Study

Area of Science:

• Ophthalmology
• Retinal Diseases
• Health Equity

Background:

• Consistent follow-up is crucial for preventing vision loss in diabetic retinopathy (DR).
• Language barriers can lead to patient non-adherence and loss to follow-up (LTFU).
• The impact of language discordance on DR follow-up, even with interpreter services, requires further investigation.

Purpose of the Study:

• To compare follow-up adherence between Spanish-speaking patients with interpreters (SSI) and English-speaking (ES) patients receiving intravitreal injections for DR.
• To determine if language discordance impacts follow-up when interpreter services are provided.

Main Methods:

• Retrospective cohort study of DR patients receiving anti-VEGF injections from 2012-2022.
• Patients categorized as SSI or ES based on preferred language; interpreter services offered to all SSI patients.
• Adherence defined as clinic visits within 1 month of recommended time; LTFU defined as no visits within 12 months of injection.

Main Results:

• No significant difference in adherence rates after initial visit or injections between SSI (78.9%-80.7%) and ES (82.8%-82.3%) groups.
• Similar overall LTFU rates (57.9% SSI vs 67.2% ES), but differing patterns of LTFU.
• SSI status was protective against LTFU (aHR 0.534; p=0.024), indicating better retention with interpreter services.

Conclusions:

• Interpreting services effectively mitigate the negative impact of language discordance on patient follow-up in DR care.
• Spanish-speaking patients with interpreters demonstrated comparable or superior follow-up adherence.
• The findings highlight the value of interpreter services in retina specialty care and suggest future prospective studies.