Pharmacies May Not Be Providing Adequate services To Their Patients With Limited English Proficiency, USA

Main Category: Pharmacy / Pharmacist
Article Date: 07 Aug 2007 - 1:00 PDT

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A survey of pharmacies by a UT Southwestern researcher suggests that many may not be providing adequate services to their patients with limited English proficiency.

The study, the first to evaluate pharmacies' abilities to provide non-English language prescription labels, pharmaceutical information packets and verbal communication and to assess their satisfaction with communication with their patients, appears in the August issue of the journal Pediatrics.

The study also identified "model" pharmacies that do have effective ways to communicate with LEP patients. Those pharmacies hired bilingual staff members and incorporated computer-translating programs and telephone interpreting services.

Dr. Glenn Flores, newly recruited to lead general pediatrics at UT Southwestern and senior author of the study, recommends physicians and their staffs alert local pharmacies if a patient does not understand English. He also said the needs of patients with limited English proficiency cannot be ignored.

"This is an issue that will come up over and over again, it's not going away," Dr. Flores said. "Ignoring the problem risks patient safety. Better standards of care for patients with limited English need to be developed, along with improved access to bilingual and multilingual materials."

In the study Dr. Flores and his colleagues at the Medical College of Wisconsin, where he was a professor of pediatrics, analyzed findings from surveys distributed to 175 Milwaukee-area pharmacies, which included those embedded in supermarkets or retail stores.

The surveys evaluated the pharmacies' abilities to provide non-English prescription labels, pharmaceutical information packets and verbal communication to patients with limited English proficiency. Additional questions addressed the pharmacies' satisfaction with their ability to communicate with these patients. Forty-five questions were posed by phone, fax or mail. A total of 128 pharmacies responded.

The study's analysis showed that 47 percent of the participating pharmacies never or only sometimes printed non-English prescription labels; 54 percent never or only sometimes prepared non-English pharmaceutical information packets; and 64 percent never or only sometimes orally communicated in a language other than English.

Additionally, almost two-thirds of the pharmacies reported never or only sometimes being able to orally communicate with these patients. Only 55 percent of the pharmacies reported being satisfied with their patient communication.

"Almost half of pharmacies surveyed were unhappy with their patient communication. This is troubling, especially when you consider 52 million people in America speak a language other than English at home, and 23 million Americans have limited English proficiency," Dr. Flores said. "More than 4 billion prescriptions are written each year in the United States, and we estimate as many as 336 million English prescriptions are written each year for limited English patients. If what's happening in Milwaukee County pharmacies is occurring nationally, there exists a serious risk for medical error and injury."

The survey also indicated that one in nine pharmacies verbally instructed patients by having family members or friends act as interpreters. Dr. Flores said this, too, increases the possibility of communication mistakes and medical error or injury.

"Even when a family member or friend speaks En glish, prescriptions can be difficult to understand and translate because of the science and jargon involved," Dr. Flores said. "Pharmacies should be discouraged from this practice and use it only as an absolute last resort."

The study was funded through a grant from the National Heart, Lung and Blood Institute.

UT Southwestern Medical Center

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