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APHA Scientific Session and Event Listing

Recorded presentation

Michael Bradshaw¹, Richard Hayney, RPh², Emmanuel Ngui, DrPH, MSc³, and Glenn Flores, MD³. (1) Medical College of Wisconsin, 2433 N. 111th St. #2, Milwaukee, WI 53226, (414) 258-7901, mbradsha@mcw.edu, (2) Director of Professional Affairs, Pharmacy Society of Wisconsin, 701 Heartland Tr, Madison, WI 53717, (3) Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226

Background: 21 million Americans are LEP. Language barriers can have major adverse consequences in healthcare, but little is known about whether pharmacies provide adequate care to LEP patients. Objective: To contact all Milwaukee County pharmacies to evaluate the ability to provide prescription labels, information packets, and oral communication in non-English languages (NELs), assess satisfaction with LEP patient communication, and identify features of model pharmacies. Study Design: In this cross-sectional survey of Milwaukee County pharmacies, a pharmacist or technician at each pharmacy was asked 45 questions by phone, fax or mail. Principal Findings: 73% of 175 pharmacies responded. 47% of pharmacies never/only sometimes can print NEL prescription labels, 54% never/only sometimes can prepare NEL information packets, and 64% never/only sometimes can orally communicate in NELs. For pharmacies that orally communicate in NELs, 11% used patient family members or friends to interpret. Only 55% of pharmacies were satisfied with their LEP patient communication. In multivariate analyses, ability to orally communicate in NELs was significantly associated with chain pharmacies (OR=3.2 [1.1-9.0]), phone interpreter use (OR=2.9 [1.1-7.3]), and community pharmacies (OR=0.2 [0.1-0.5]). Pharmacies suggestions for improving LEP patient communication included continuing education; chain-wide lists of resources to call; hiring bilingual staff; using phone interpreters; analyzing translation quality/accuracy of labels and information packets; and adding more languages to pharmacy software. Model pharmacies shared a combination of validated NEL computer programs, bilingual staff, and phone interpreters. Conclusions: About half of pharmacies surveyed never/only sometimes can print NEL prescription labels, prepare NEL information packets, or orally communicate in NELs. Almost half are unsatisfied with their LEP patient communication, and 1 in 9 pharmacies that orally communicate in NELs use patient family members/friends to interpret. Chains and those using phone interpreters are more likely and community pharmacies are less likely to be able to orally communicate in NELs. Improvements in pharmacies' LEP patient communication may result by increasing bilingual staff, the quality and number of NELs in existing computer programs, phone interpreter use, and continuing education. Implications for Policy, Delivery or Practice: The study findings suggest that many urban pharmacies may not be providing adequate services to LEP patients, thereby increasing the risk of compromised patient safety. Excellent communication with LEP patients can be achieved by using validated computer programs to prepare NEL prescription labels and information packets, hiring bilingual staff, and using phone interpreters when in-person interpreters are unavailable, as already occurs in certain model pharmacies.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize langauge barriers to care at pharmacies for limited English proficient (LEP) patients.
• Identify the pharmacy risk factors for poor communication with LEP patients.
• Identify the features of model pharmacies for exceptional communication with LEP patients.

Keywords: Health Disparities, Pharmacies

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation