Language Barriers Plague Almost Half of U.S. Drug Stores

One pharmacy that clearly has given thought to this issue is Maimonides Medical Center in New York City, which serves a patient base speaking some 60 to 70 languages and dialects, according to president and CEO Pamela Brier, who also was not involved in the study.

The hospital's pharmacy services provide prescribing information (but not labels) in any of 10 core languages, including English, Spanish, Mandarin, Cantonese, Russian, Italian, Urdu, Arabic, French, and Polish, and has made it a point to hire staff fluent in these languages, Brier said. Telephone interpreter services and multilingual (non-pharmacy) staff help fill in the gaps. The women's clinic has seen an increase in Bangladeshi patients, for instance.

"It is a big, big problem in urban care," Brier says. "I don't get how you take care of people if you don't speak the language and understand the culture, it's just not possible."

Language barriers can have real medical consequences, Flores said. He noted the case of a child with iron-deficiency anemia who was hospitalized after her Spanish-speaking parents gave her a 12.5-fold overdose of her medicine, because they misunderstood the prescription label. It read "15 mg [milligrams] per 0.6 mL [milliliters], 1.2 mL daily." They interpreted that to mean, administer 15 mL.

One thing non-English-speaking patients can do to help themselves, Flores said, is ask their physicians to indicate on their prescriptions that the label and/or associated information be provided in a language the patient understands. Also, they should let the pharmacist know when they do not understand the information provided.

"I think that combination may help stimulate pharmacists to know this is an important issue. This is compromising patient safety, so let's do something about this," he said.

More information

For health information in Spanish (or any of 9 other languages), visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Glenn Flores, M.D., director, division of general pediatrics, and professor, pediatrics and public health, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; Robert Schwartz, M.D., professor and chair, family medicine and community health, University of Miami Miller School of Medicine; Pamela Brier, president and CEO, Maimonides Medical Center, Brooklyn, N.Y.; August 2007,Pediatrics