Surprisingly few pharmacies in the U.S. are able to translate prescription medication instructions into Spanish, making it difficult for patients who speak only Spanish to understand how to take their medications properly, according to a new study from the Northwestern University Feinberg School of Medicine.
The first multi-state study investigating the ability of pharmacies to translate prescription labels found more than half of the pharmacies were unable to translate any labels or could do only a limited number of translations. The study looked at pharmacies in states with a large existing Latino population (Texas and Colorado) and in states with a rapid growth in Latino population (Georgia and North Carolina). These states -- because of their large Latino populations -- are likely to have the greatest demand and capability for translation. Other states may be further behind, researchers said.
"The lack of translation for prescription medication instructions is a major problem," said lead author Stacy Cooper Bailey, clinical research associate and director of the Health Literacy and Learning Program at Northwestern's Feinberg School. "If you don't know how to take your medications correctly, it is going to be difficult for you to manage your medical condition. Taking medications incorrectly could cause serious problems or even death."
The study will appear in the June issue of the journal Medical Care.
Bailey said the study results indicate the overall problem is far more prevalent than what had been suggested in prior single-site studies conducted in New York and Milwaukee.
Bailey and colleagues surveyed 764 pharmacies, including national chains, in four states. The study found 34.9 percent (267) could not offer any translation services; 21.7 percent (166) offered only limited translation services and 43.3 percent (331) said they could provide translated instructions. Of the total, 28 percent were independent pharmacies and 72 percent were part of national, regional or state chains.
The data also showed that 44 percent of pharmacies located in counties where the Latino population exceeds a quarter of the population were unable to provide comprehensive Spanish medication instructions.
"The numbers are much worse than I anticipated," Bailey said.
"A lot of effort has gone into improving language services in hospitals, but pharmacies have been overlooked," Bailey said. "That is unfortunate because a lot of people take medications. It's one of the most common health tasks that you have to perform. Knowing how to take your medications correctly is essential."
Bailey said some pharmacists report being afraid to use translations because they don't know what the Spanish translations mean. "They worry they are giving an incorrect instruction and they will be liable for it," Bailey said. "Pharmacies also may not be aware of software programs that offer translations," she added.
Availability of translations is likely to be even worse for people who speak a language other than Spanish, Bailey said. "We have to be able to provide medication instructions in multiple languages, even beyond Spanish. More laws need to be passed to guide and enforce language services in pharmacies. We also need to come up with innovative ways of helping pharmacies provide these services. There are ways to overcome this obstacle."
- Bailey, Stacy Cooper; Pandit, Anjali U.; Curtis, Laura; Wolf, Michael S. Availability of Spanish Prescription Labels: A Multi-State Pharmacy Survey. Medical Care, 2009; 47 (6): 707-710 DOI: 10.1097/MLR.0b013e318195fd02
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