How does limited English proficiency affect the ability of a patient to understand the dosage instructions of his or her prescription drug medication? In the April edition of the journal Ethnic Health, researchers from the University of California, Berkeley, used the 2007 California Health Interview Survey (CHIS) to examine this question among five groups: Mexicans, Central Americans, Chinese, Koreans and Vietnamese. The researchers found that limited English increased the odds of difficulty in understanding prescriptions by three times for Mexicans, Central Americans, and Koreans, and four times for Chinese (only among Vietnamese was the difference insignificant). Those with a bilingual doctor were, perhaps predictably, less likely to experience difficulties, while disability, low education, low income or recent immigration increased the odds of a patient experiencing difficulty.
The findings suggest that culturally appropriate and “linguistically-concordant” interventions, such as translated prescription labels, interpreted in-person pharmacy consultations, and the presence of bilingual and bicultural providers, may help improve drug adherence. In particular, the authors recommend that linguistic, cultural or educational needs be noted in a patient’s record or on the prescription so that pharmacy staff may be alerted and respond appropriately. Such interventions are particularly needed for the chronically ill, disabled, recent immigrants, low-income or rural inhabitants.