Work

SUN-234 Implementation of a Fluent Spanish-Language, Direct-to-Patient Primary Aldosteronism Testing Program

Year: 2025

Type: article

Abstract: Disclosure: A. Ferrebus: None. L.C. Tsai: None. E.E. Abel: None. K. Foote: None. A.J. Newman: None. S. Parisien-La Salle: None. A. Vaidya: Corcept Therapeutics, HRA Pharmaceuticals, Mineralys. J.M. Brown: AstraZeneca, Bayer, Inc.. Background: Despite guideline recommendations to screen for primary aldosteronism (PA), fewer than 2% of eligible patients are ever tested. Beyond clinician awareness and education, patients’ language and cultural preferences are key considerations for optimal screening for PA. Using medically fluent interpreters and communications, we conducted a nationwide, direct-to-patient PA testing program focused on Spanish-speaking people in the United States. Methods: Spanish-speaking adults with hypertension meeting guidelines-based PA screening indications were recruited from the Boston, New York, Miami, Houston, and Los Angeles metropolitan areas using online platforms. All patient-facing documents, including social media advertisements, consent forms, and questionnaires, were delivered in Spanish. Eligible participants underwent virtual informed consent and medical history review with a bilingual member of study staff before completing local phlebotomy to test for PA. Results were interpreted centrally using a standardized algorithm, and results, with their interpretations, were communicated to patients in Spanish and to primary care providers in English. Clinical follow-up was ascertained at 6 months among those testing positive for PA. The primary outcome was the frequency of a positive test for PA. Secondary outcomes included follow-up PA testing, initiation of aldosterone-targeted therapies, and quality of life impact. Results: The study population (N=155) had a mean age of 59.7 ± 9.5y and was 66.5% female. 77.4% reported limited English proficiency, and the Caribbean was the most frequent region of reported personal or familial origin, followed by South America, Mexico, and Central America. 30.3% of participants tested positive for PA. The most common testing indication was family history of premature hypertension or stroke (69.7%), followed by resistant hypertension, hypokalemia, or sleep apnea in 20-25% each; 32.9% of patients had ≥2 indications to test for PA. Of participants with a positive result, 10.3% had additional clinical follow-up testing for PA and 6.9% were started on a mineralocorticoid receptor antagonist. Inability to access care and dismissal of results by their physicians were among the cited reasons for lack of clinical follow-up regarding PA; however, study participation was viewed favorably: 79.3% reported the study increased their awareness about health and 69.0% felt more empowered about their medical care. Conclusions: This fully Spanish-language program of direct-to-patient PA testing and communication of interpreted results identified PA in over 30% of patients and influenced care in a manner that was highly acceptable to patients. Targeted efforts that prioritize access and break down language barriers will be crucial to address the high prevalence of hypertension in the growing population of Spanish speakers in the United States. Presentation: Sunday, July 13, 2025

Source: Journal of the Endocrine Society

DOI: 10.1210/jendso/bvaf149.852