Interventions for End of Life Decision Making for Patients with Limited English Proficiency

  • Amelia BarwiseEmail author
  • Joyce Balls-Berry
  • Jalal Soleimani
  • Bibek Karki
  • Brandon Barrett
  • Katerina Castillo
  • Samantha Kreps
  • Hilary Kunkel
  • Beatriz Vega
  • Patricia Erwin
  • Nataly Espinoza Suarez
  • Michael E. Wilson
Original Paper


Patients with limited English proficiency (LEP) experience disparities in end-of-life decision making and advance care planning. Our objective was to conduct a systematic review to assess the literature about interventions addressing these issues. Our search strategy was built around end-of-life (EOL), LEP, ACP, and goals of care. The databases included Ovid MEDLINE(R), and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily from 1946 to November 9, 2018, Ovid EMBASE. Eight studies from the US and Australia were included (seven studies in Spanish and one study in Greek and Italian). Interventions used trained personnel, video images, web-based programs, and written materials. Interventions were associated with increased advance directive completion and decreased preferences for some life-prolonging treatments. Interventions were deemed to be feasible and acceptable. Few interventions exist to improve end-of-life care for patients with LEP. Data are limited regarding intervention effectiveness.


LEP Limited english proficiency End-of-life decision making End-of-life care Advance care planning Advance directive Disparities Interventions Systematic review 



This study was supported by Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The authors have not disclosed any potential conflicts of interest.

Supplementary material

10903_2019_947_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 18 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Amelia Barwise
    • 1
    Email author
  • Joyce Balls-Berry
    • 2
  • Jalal Soleimani
    • 3
  • Bibek Karki
    • 1
  • Brandon Barrett
    • 4
  • Katerina Castillo
    • 4
  • Samantha Kreps
    • 5
  • Hilary Kunkel
    • 4
  • Beatriz Vega
    • 4
  • Patricia Erwin
    • 6
  • Nataly Espinoza Suarez
    • 7
  • Michael E. Wilson
    • 1
    • 7
  1. 1.Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterUSA
  2. 2.Office for Community Engagement in Research, Center for Clinical and Translational Science, Division of EpidemiologyMayo ClinicRochesterUSA
  3. 3.Department of AnesthesiologyMayo ClinicRochesterUSA
  4. 4.Mayo Clinic Alix School of MedicineRochesterUSA
  5. 5.Health SciencesUniversity of MinnesotaRochesterUSA
  6. 6.Department of Education AdministrationRochesterUSA
  7. 7.Knowledge Evaluation Research UnitMayo ClinicRochesterUSA

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