A qualitative study found that patients with limited English proficiency were willing to engage in technology-based interventions.

There is growing interest for utilizing electronic tools aimed at improving patient health and communication with providers. Most of these tools are aimed at patients who are proficient in English. Adapting these tools for patients with limited English proficiency may address gaps in care experienced by this community, such as delays in referrals, lower enrollment in clinical trials, and more unplanned emergency department visits.

This study was conducted at the Dana-Farber Cancer Institute in 2019. Patients who were Spanish-speaking and had limited English proficiency (10 patients) and patients who were proficient in English (36 patients) using oral therapies for gastrointestinal or breast cancers were invited to participate in focus groups lasting approximately 90 minutes. The focus groups examined the patient’s attitudes towards electronic patient-reported outcome tools (ePROs).

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In the limited English proficiency focus group, patients indicated their clinician had not explained potential oral therapy side effects, which caused a general dislike or fear of these therapies. This was particularly important as few patients said they did independent research about their treatments. The patients welcomed the idea of using an electric device to report symptoms or ask questions to their provider.

The focus groups that included patients who were proficient in English had a positive attitude about oral cancer therapies because of the convenience. The group had concerns about side effects, costs, and food restrictions. In addition to their clinician, they endorsed obtaining information from pharmacists, online, and peers. Use of ePROs would likely depend on each patient, as attitudes about electronic tools varied.

This study had a low sample size for the limited English proficiency group and trends may not be generalizable to speakers of other languages.

This study found that patients with limited English proficiency taking oral cancer medications were open to the idea of using language-adapted ePROs, which may help address unmet needs in this population.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Farina EG, Rowell J, Revette A, et al. Barriers to electronic patient-reported outcome measurement among patients with cancer and limited English proficiency. JAMA Netw Open. 2022;5:e2223898. doi:10.1001/jamanetworkopen.2022.23898