Patient-Provider Satisfaction Survey Affected by Cultural Norms in Hispanic/Latinx Patients with RA

CreakyJoints recently presented data at the European Alliance of Associations for Rheumatology (EULAR) 2022 conference demonstrating that patient-reported satisfaction is affected by both social and cultural norms in Spanish-speaking patients with rheumatoid arthritis (RA) in the United States and Puerto Rico.

THE STUDY

The study utilized a Spanish-language patient-provider questionnaire (PPQ) for Hispanic/Latinx patients with RA, which was previously validated in Sweden, to determine if rheumatologists and patient assessments are consistent when applied to a Spanish-language digital PPQ. Ultimately, the goal was to evaluate whether a Spanish-language rheumatologist-completed PPQ could be used as a proxy for patient-reported impressions. The survey, which translated 9 of the 13 questions from the Swedish study with an additional question related to treatment to target goals in RA, was accessible via tablet devices in 4 rheumatology clinics in the US and Puerto Rico. Consent and demographic information were obtained by clinic staff.

THE RESULTS

Of 114 clinical visits, 96.7% of answers were positive, with 88% reporting 5 scores (strongly agree) and 12% rating their satisfaction as a 4 (agree). When investigators paired the answers, 80.67% reported the same response from both patient and their physician. Interestingly, rheumatologists responded with a rating of 4 more often when compared with patients (18% vs 6%, respectively).

As Hispanic/Latinx patients with RA and their rheumatologists overwhelmingly scored their goal setting, relationships, and communication positively, investigators were ultimately unable to evaluate true concordance and could not use rheumatologist-completed patient-provider questionnaires (PPQs) as a proxy for patient-reported assessments. Findings, which were significantly different from typical Likert scales, may reflect heterogeneity within the participants, social determinants of health and possible cultural differences including a bias towards positive statements about clinician interactions. Further research may help to determine the best strategies for measuring treatment to target and physician interactions within this patient population.

“Researchers found [the high levels of agreement between patients and physicians] problematic for several reasons,” Daniel Hernandez, MD, Director of Medical Affairs and Hispanic Outreach for the Global Healthy Living Foundation, stated. “These results provide valuable information about how cultural norms within the Hispanic community in the US and Puerto Rico require us to dig deeper to create measures that work specifically for this patient population.”

Investigators hypothesize this may be in part due to a lack of Spanish-language educational materials and research tools for this patient population. However, current research being performed at CreakyJoints Español measuring the effectiveness of Spanish language education materials for newly diagnosed patients may help to create future tools and improve disease outcomes.