Dr Regueiro reviews the award-poster his team from Cleveland Clinic presented at Digestive Disease Week 2024 on disparities in access to care for inflammatory bowel disease—including the use of advanced therapies—differs among non-English speaking patients vs those who speak English as a first language. 

Miguel Regueiro, MD, is professor of medicine and chair of the Digestive Disease Institute at Cleveland Clinic in Cleveland, Ohio. 

TRANSCRIPT:

I'm Dr. Miguel Regueiro. I'm the chief of the Digestive Disease Institute and professor of Medicine at Cleveland Clinic in Cleveland, Ohio.

At DDW 2024, we had an exciting poster that actually won the Healthcare Research Disparities Award by the AGA Council as the top poster at DDW 2024. This was a collaborative study that we did out of Cleveland between Cleveland Clinic and University Hospitals using a large database. And what we found and studied were non-English speakers.

We know that there are health care disparities that exist in the treatment today of any medical diseases. But something that we've never really looked at before is in our inflammatory bowel disease patients, our patients with Crohn's disease or ulcerative colitis, is what if English is not their first language, so the non-English speakers? So we divided the group into those that had English as their primary language and those that were non-English, where English was not their primary language. And we looked at unplanned care, such as hospital care.

We also looked at medication use, meaning medications that we would use for inflammatory bowel disease. And what we found was interesting. The non-English speakers had higher rates of hospitalizations, unplanned care, for their IBD, compared to those that were English speakers.

Also what was interesting and maybe a little bit surprising were that the non-English speakers had lower rates of advanced therapy use for inflammatory bowel disease, meaning the biologics, the oral small molecules—what we would consider the more effective therapies. These were lower in the non-English speakers than the English speakers.

And then we did a subgroup analysis to see which language may be most affected and we found that it was more in our Spanish-speaking patients and especially more in females. So I think the take-home message from this is that as we look at and treat inflammatory bowel disease we need to keep in mind the patients that do not have English as their first language and maybe take the extra step in terms of considerations of treatment for them.

So hopefully this was a study that will inform other studies in the future. It was the first of its kind and we're very proud that it won an award.