Some Calif. Pharmacies Do Not Offer Written Translations of Rx Labels

Many pharmacies across California do not provide written translations for prescription instructions, which health care advocates say could pose serious risks for patients who speak little to no English, HealthyCal reports.

The issue will be discussed next month during a meeting of the California Board of Pharmacy -- which regulates all pharmacies in the state.

Background

According to recent census data, about 44% of California residents speak a language besides English, and more than half of such residents speak limited or no English. In addition, experts have estimated that about one-third of the three million California residents who have gained health coverage through the Affordable Care Act will speak limited English, according to Cary Sanders, director of policy analysis at the California Pan-Ethnic Health Network.

There are no federal requirements that regulate medication instruction translations. However, a state law (SB 472) passed in 2007 requires the California Board of Pharmacy to create patient-friendly labeling rules.

Subsequently, the board began offering on its website standard dose instructions in Chinese, Korean, Russian, Spanish and Vietnamese. However, state law does not require that pharmacies use the translations, and many do not, HealthyCal reports.

California Board of Pharmacy CEO Virginia Herold said a survey of more than 200 pharmacies in the state found that about 70% offered some sort of prescription instruction translations, but the quality of such translations is unknown because not many used the translations provided on the board's website.

State residents have the right to no-cost oral translations of prescription labels and instructions offered via a hotline or pharmacy staff.  Since 2011, California pharmacies have been required to display:

• A poster with information about this right; and
• A series of phrases at the pharmacy counter that individuals can physically point to so that a pharmacist knows they are requesting a translation in their native language.

Problem with Lack of Translations

Doreena Wong, project director for Los Angeles-based Asian Americans Advancing Justice, said the state-mandated oral translations are not adequate, adding, "Even if you had a bilingual pharmacist and they can explain (the label) directly, when you go home there's a problem of remembering how you're supposed to take your medication, especially if you have more than one medication."

Health care advocates say that patients could endanger themselves or individuals they are caring for by misreading or misunderstanding prescription drug instructions that are not printed in their primary language.

Wong said, "If you can't communicate effectively with your provider or understand how to take medication, it doesn't take much imagination to realize there's going to be problems." For example, Wong said the Spanish word for "once" also could be read to mean "11."

Pharmacies Cite Liability Concerns

California Pharmacists Association CEO Jon Roth said that liability concerns are the primary reason his organization does not support a translation requirement.

"It really comes down to that professional liability that would occur and the potential errors that could result from just one small character being off and the pharmacist not being competent in that language to be able to catch that," Roth said (Boyd-Barrett, HealthyCal, 6/25).