In a recent discussionYesterday, I spoke with a woman originally from Brazil, and she casually noted that her parents were in the US visiting her family, and her father had to get his medical prescription filled during his stay. Since he was not a native English speaker, he experienced significant difficulty understanding the dosage directions on the prescription label, until his daughter intervened to help.
Not everyone is this lucky.
This blog examines the issue of nNon-native English speakers face these challenges all the time. There are , and four major factors pharmacists need to keep in mind when thinking about this emerging cohort of patients and their medication needs.
1. The Limited English Proficiency (LEP) Population Is Large
The Health and Human Services department of the US government definesLEP as someone whose primary language is not English, and has difficulty speaking, reading or understanding English.
- According to KFF.org, an independent source for US Health Policy research, policy and news, as of 2021, 25.7 million or 8% of people ages five or older living in the United States had LEP.
- 9 out of 10 LEP people were adults and among them, > 60% is Hispanic, i.e. Spanish speaking).
- The Vietnamese population was the Asian-origin group with a high percentage being LEP.
A significant majority of LEP people live in households within the lower strata of income and educational attainment levels. They frequently do not have health insurance. In other words, this is a disadvantaged segment of society and needs help in most aspects of their lives, especially their healthcare needs.
2. Accurate Medication Instructions Can Be A Matter Of Life and Death
According to the Institute of Medicine, medication errors stemming from all causes can lead to 1 of 131 outpatient deaths, and 1 of 854 inpatient deaths. In total, as many as 1.5 million people each year may be impacted by medication errors. This is a matter of life and death.
When it comes to Pharmacies and LEP patients, the ideal approach is to prevent errors before they occur. The most important job of anyone who works in the pharmacy is to ensure that every LEP patient receives the most accurate medication. It is for this disadvantaged population that any medical errors can lead to a disproportionate adverse effect on their lives.
3. Language Has A Positive Impact On Patient Care and Outcomes
A recent NIH study that reviewed the quality of care and outcomes for LEP patients, showed that health disparities due to language barriers can be reduced when care is provided by language-conversant health care professionals. LEP patients benefited by receiving more education about their care, had fewer unresolved questions, and displayed better medication adherence. Patient satisfaction with care was also higher when language-specific care was provided.
LEP patients are also at a higher risk for adverse events than English-proficient patients. Language barriers significantly impact safe and effective health care, including a:
- A greater risk of infections and a .
- A greater chance of readmissions for certain chronic conditions due to difficulty understanding how to take their medications.
4. Effective Communication Builds Trust and Compliance
As health systems continue to adopt a more patient-centered approach to care, it’s important to consider the role communication plays in improving the overall LEP patient experience. For LEP patients, language barriers contribute to a range of challenges – including misunderstandings that can impact care delivery. For example, a recent report highlighted how patients with LEP make medication dosing errors twice as often. Effective communication builds trust, and the level of confidence that an LEP patient has will greatly impact the degree to which they will adhere to a required medication regimen.
Conclusion
Prescription label accuracy is of vital importance to a significant segment of the population, i.e. LEP patients. By ensuring that accurate medication translations are available to the non-English speakers in your community, you build trust, which can be the major factor in better patient care and outcomes.
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