Journal of General Internal Medicine

, Volume 27, Issue 12, pp 1707–1713

Evaluation of Language Concordant, Patient-Centered Drug Label Instructions

  • Stacy Cooper Bailey
  • Urmimala Sarkar
  • Alice Hm Chen
  • Dean Schillinger
  • Michael S. Wolf
Original Research

DOI: 10.1007/s11606-012-2035-3

Cite this article as:
Bailey, S.C., Sarkar, U., Chen, A.H. et al. J GEN INTERN MED (2012) 27: 1707. doi:10.1007/s11606-012-2035-3

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.

KEY WORDS

health literacy prescription medication drug labeling limited English proficiency 

Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Stacy Cooper Bailey
    • 1
  • Urmimala Sarkar
    • 2
    • 3
  • Alice Hm Chen
    • 2
  • Dean Schillinger
    • 2
    • 3
  • Michael S. Wolf
    • 1
  1. 1.Health Literacy and Learning Program, Division of General Internal MedicineFeinberg School of Medicine at Northwestern UniversityChicagoUSA
  2. 2.Division of General Internal Medicine, San Francisco General HospitalUniversity of California at San FranciscoSan FranciscoUSA
  3. 3.University of California at San Francisco Center for Vulnerable PopulationsSan Francisco General HospitalSan FranciscoUSA

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