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Availability of Spanish Prescription Labels: A Multi-State Pharmacy Survey

Bailey, Stacy Cooper MPH*; Pandit, Anjali U. MPH*; Curtis, Laura MA*; Wolf, Michael S. PhD, MPH*†

doi: 10.1097/MLR.0b013e318195fd02
Brief Report

Background: Patient misunderstanding of prescription drug label instructions is a leading cause of medication errors. Among Latino patients, limited English proficiency is a major barrier to comprehension of medication instructions.

Objectives: To determine the availability of Spanish prescription drug label instructions.

Research Design: A telephone survey was conducted in 4 states selected due to either a rapid growth in their Latino population (GA, NC) or a large, existing Latino population (CO, TX).

Subjects: A list of retail pharmacies was obtained from each state board of pharmacy. A simple random sample of 10 percent of pharmacies within each state was generated (N = 764).

Measures: The ability of pharmacies to print prescription instructions in Spanish and the process for translating instructions.

Results: Two hundred sixty-seven (34.9%) pharmacies reported no translation services, 166 (21.7%) reported limited translation services, and 331 (43.3%) stated they were able to perform translations. In bivariate analyses, significant differences between pharmacy characteristics and the availability of Spanish labels were noted. In multivariate analysis including pharmacy type, location, percentage Latino population, and state, only metropolitan location was found to be a significant independent predictor of pharmacies offering full Spanish translation services (adjusted odds ratio: 1.72, 95% confidence interval: 1.04–2.84).

Conclusions: The majority of pharmacies surveyed offered limited or no translation services. Lack of translation services is not isolated to rural areas or locations with a marginal Latino population. Spanish-speaking patients encounter barriers to acquiring instructions that support the safe and effective use of medications.

From the *Health Literacy and Learning Program, Northwestern University, Chicago, Illinois; and †Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

Reprints: Stacy Cooper Bailey, MPH, Health Literacy and Learning Program, Center for Communication in Healthcare, Northwestern University, 750 N Lake Shore Drive, 10th Floor, Chicago, IL. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.