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Evaluation of Language Concordant, Patient-Centered Drug Label Instructions

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ABSTRACT

BACKGROUND

Despite federal laws requiring language access in healthcare settings, most US pharmacies are unable to provide prescription (Rx) medication instructions to limited English proficient (LEP) patients in their native language.

OBJECTIVE

To evaluate the efficacy of health literacy-informed, multilingual Rx instructions (the ConcordantRx instructions) to improve Rx understanding, regimen dosing and regimen consolidation in comparison to standard, language-concordant Rx instructions.

DESIGN

Randomized, experimental evaluation.

PARTICIPANTS

Two hundred and two LEP adults speaking five non-English languages (Chinese, Korean, Russian, Spanish, Vietnamese), recruited from nine clinics and community organizations in San Francisco and Chicago.

INTERVENTION

Subjects were randomized to review Rx bottles with either ConcordantRx or standard instructions.

MAIN MEASURES

Proper demonstration of common prescription label instructions for single and multi-drug medication regimens. Regimen consolidation was assessed by determining how many times per day subjects would take medicine for a multi-drug regimen.

KEY RESULTS

Subjects receiving the ConcordantRx instructions demonstrated significantly greater Rx understanding, regimen dosing and regimen consolidation in comparison to those receiving standard instructions (incidence rate ratio [IRR]: 1.25, 95 % confidence interval [CI]: 1.06-1.48; P = 0.007 for Rx understanding, IRR: 1.19, 95 % CI: 1.03–1.39; P = 0.02 for regimen dosing and IRR: 0.76, 95 % CI: 0.64–0.90; P = 0.001 for regimen consolidation). In most cases, instruction type was the sole, independent predictor of outcomes in multivariate models controlling for relevant covariates.

CONCLUSIONS

There is a need for standardized, multilingual Rx instructions that can be implemented in pharmacy practices to promote safe medication use among LEP patients. The ConcordantRx instructions represent an important step towards achieving this goal.

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Acknowledgements

Preliminary findings from this study were presented at the International Conference for Communication in Healthcare in Chicago, IL, October 2011 and the Society of General Internal Medicine in Phoenix, AZ, May 2011.

Funding

The findings presented are from a research study sponsored by the California Endowment.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, 750 N Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA

    Stacy Cooper Bailey PhD, MPH & Michael S. Wolf PhD, MPH

  2. Division of General Internal Medicine, San Francisco General Hospital, University of California at San Francisco, San Francisco, CA, USA

    Urmimala Sarkar MD, MPH, Alice Hm Chen MD, MPH & Dean Schillinger MD

  3. University of California at San Francisco Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, CA, USA

    Urmimala Sarkar MD, MPH & Dean Schillinger MD

Authors
  1. Stacy Cooper Bailey PhD, MPH
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  2. Urmimala Sarkar MD, MPH
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  3. Alice Hm Chen MD, MPH
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  4. Dean Schillinger MD
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  5. Michael S. Wolf PhD, MPH
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Corresponding author

Correspondence to Stacy Cooper Bailey PhD, MPH.

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Bailey, S.C., Sarkar, U., Chen, A.H. et al. Evaluation of Language Concordant, Patient-Centered Drug Label Instructions. J GEN INTERN MED 27, 1707–1713 (2012). https://doi.org/10.1007/s11606-012-2035-3

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  • DOI: https://doi.org/10.1007/s11606-012-2035-3

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