Pharmacy Translations

Miscommunication in the healthcare field can lead to poor health outcomes and can potentially even be life-threatening. There are a rising number of migrant patients as well as a high number of foreign-trained healthcare practitioners in the United States. This can lead to increased communication barriers between a healthcare practitioner and patient when one or both are speaking English as a second language. The lack of thorough understanding of one’s own medical condition, as well as poor understanding of the treatment and follow-up plan can lead to a number of problems. These problems may include but are not limited to poor adherence to treatment plans consisting of medications and/or diet and lifestyle recommendations, which can lead to uncontrolled health conditions, poor health outcomes, and increased morbidity and mortality. Patients with low health literacy are often associated with poor health outcomes, increased hospitalizations, and an overall decreased quality of life1.Taking the time to ensure a patient’s proper understanding of points discussed with the healthcare team can result in better outcomes and decreased costs to the individual patient, clinic, and health system. Patients with language barriers are also less likely to have a consistent provider of medical care leading to a poor continuity of care further contributing to the array of health problems a patient may face. Language barriers can deter patients to ask questions about their treatment and prevent them from taking an active role in managing their overall health. It is important to overcome these language and communication barriers so we can have a positive effect on patients and support them in becoming champions of their own health. 

The resources provided below can be used to overcome these language barriers:

ResourceDescriptionLanguages Available for Patient MaterialsCost
RxTranRxTran offers pharmacies the service of providing prescription drug labels, auxiliary labels, and patient medication guides in different languages. Currently they offer SIG translation into 17 different languages. The also offer over the phone interpreting in over 150 languages available 24/7. http://www.rxtran.com/ 



*Figure 1-2
English, Arabic, Bengali, Chinese (traditional & simplified), French, German, Greek, Haitian Creole, Hindi, Korean, Italian, Polish, Portuguese, Russian, Spanish, Tagalog, Vietnamese$80-100/ month depending on number of locations, pharmacy software, and languages needed
MeducationMeducation is a cloud-based solution, accessible to healthcare providers within their clinical workflow via their EMR system or as a standalone solution, which delivers medication instructions.http://www.fdbhealth.com/meducation-overview/ 
*Figure 3-7
Over 20 languagesContract specific pricing
VUCA HealthVUCA Health is an organization that gives patients the ability to quickly and conveniently access thousands of medication-specific videos in the MedsOnCue library by clicking on a link in an email or text message, or by scanning a QR code printed on prescription labels and patient information sheets.http://www.vucahealth.com/ 
*Figure 8
Videos available in English and SpanishContract specific pricing
LexicompLexicomp is a drug information resources that also gives you access to patient medication hand outshttp://www.wolterskluwercdi.com/lexicomp-online/ 


*Figure 9
English, Arabic, Chinese (traditional & simplified), French, German, Greek, Creole, Japanese, Korean, Italian, Polish, Punjabi, Portuguese, Russian, Spanish, Tagalog, Turkish Vietnamese-$285/year for mobile app -$795 for mobile app and online
MicromedexMicromedex is a drug information resources that also gives you access to patient medication hand outshttps://www.micromedexsolutions.com/home/dispatchEnglish, SpanishContract specific pricing
Access PharmacyAccessPharmacy is an online pharmacy resource designed to meet the demands of pharmacy education and practice today. AccessPharmacy gives instant access to videos, games, Q&A, leading pharmacy textbooks, information about drugs, herbs and supplements, as well as patient drug handouts.https://accesspharmacy.mhmedical.com/English, Spanish$595/year
Clinical KeyClinical Key is a clinical search engine that gives access to drug monographs, guidelines, journals, books, and patient education handouts.https://www.clinicalkey.com/#!/English, Spanish$499/year for internal medicine package
Medline PlusMedlinePlus is the National Institutes of Health’s website for patients and their families and friends. It provides information about diseases, conditions, drugs, supplements and wellness issues in patient friendly information. https://medlineplus.gov/English, SpanishFree
HealthReachHealthReach offers easy access to FREE quality multilingual, multicultural public health information including documents, audio, and videos for those working with or providing care to individuals with limited English proficiency.https://healthreach.nlm.nih.gov/English, Albanian, Amharic, Arabic, Armenian, Bengali, Bosnian, Burmese, Cape Verdean Creole, Chinese (traditional and simplified), Chuukese, Dari, Dzongkha, Farsi, French, German, Gujarati, Haitian Creole, Hakha Chin, Hindi, Hmong, Ilocano, Indonesian, Italian, Japanese, Karen, Karenni, Khmer, Kinyarwanda, Kirundi, Korean, Kurdish, Lao, Levantine, Malay, Marshallese, Nepali, Oromo, Pashto, Pohnpeian, Polish, Portuguese, Punjabi, Russian, Samoan, Serbo-Croatian, Somali, Spanish, Sudanese, Swahili, Tagalog, Thai, Tibetan, Tigrinya, Tongan, Turkish, Ukranian, Urdu, VietnameseFree

Recognizing language barriers in healthcare as a significant issue, some states have also started to require pharmacies to provide labeling in multiple languages to patients. The following table lists states that have requirements for multi-language labels:

StateRequirement
California*All pharmacies or facilities which dispense medication are required to provide translation of the 15 SIG codes on the Board of Pharmacy of California website. The board has interpretations of these in 5 languages which include Spanish, Chinese, Korean, Russian, and Vietnamese.
New York*Chain pharmacies are required to provide free competent oral interpretation and written translation services of prescription drug labels, auxiliary warning labels, and other written materials to limited English proficiency patients. The primary languages required are Chinese, Spanish, Russian, and Italian.
Texas*Whenever possible the directions of use on a prescription container label should be provided in the patient’s preferred language. Drug name shall be in English. Translations of prescription medication labels should be produced using high quality translation process.
North CarolinaThe NC Board of Pharmacy provides signs for pharmacies to put up for Spanish speaking patients informing patients they can obtain their prescription medication instructions in Spanish.

*These states legally require pharmacy label translation.

Figure 1: RxTran translated SIG Below are some examples of patient labels and handouts from these services.

Figure 2: RxTran Integrated into Pharmacy Software

Figure 3: NOVA Scripts use of Meducation Rx label

Figure 4: NOVA Scripts use of Meducation Rx label

Figure 5: Meducation Patient Handouts

Figure 6: Meducation Instruction Sheet

Figure 7: Meducation Handout

Figure 8: VUCA Health QR Code

Figure 9: Lexicomp Pateint Education Handout on Amlodipine in Japanese

  1. https://www.ahrq.gov/downloads/pub/evidence/pdf/literacy/literacyup.pdf

Authors:

Onkur Lal, Pharm.D. Candidate 2018 Virginia Commonwealth School of Pharmacy

Zeshan Mahmood, PharmD, Clinical Pharmacist
NOVA ScriptsCentral