P3.128: Disparities in Asthma Prescription Medication Refill Rates Based on Language-It's not what you'd think

Background: Children in households that prefer a language other than English experience healthcare inequities. Little is known about the relationship between preferred language spoken at home and adherence to asthma medications

Methods: Using claims data from a Medicaid accountable care organization from 2018-2020, we performed a retrospective cohort study to determine the association between primary language and prescription fill rates of controller medications for children aged 2-18 years with persistent asthma. Prescription fill rates were measured using proportion of days covered (PDC), a metric of adherence. PDC above 0.5 represents good adherence

Results: 6376 patients met the inclusion criteria: a diagnosis of asthma, having controller medication prescribed and reported language preference. 6169 preferred English; 214 preferred another language. Spanish was the most preferred language other than English, with Somali being the third. Overall, the PDC was good for the group regardless of language. PDC stratified by language showed similar results (Median % days covered [interquartile range%]) across language groups over 365 days of follow up: English 33% (16%,58%) vs Spanish 41% (16%,74%) vs Other 33% (16%,66%). Multivariate analysis accounted for potential confounders and found that preferred language “Other” was found to be a significant, independent predictor of 34% higher PDC, representing greater adherence (p-value 0.01).

Conclusion: Individuals who preferred a language other than English exhibited greater adherence. Further research is needed to explore factors that support adherence among those for whom English is not a primary/preferred language and what we can learn from them.