You go to the doctor to make yourself better but there have been instances where people get sicker because of mistranslated prescriptions. Non-English speakers and those whose knowledge of English is limited are vulnerable. As it is, prescriptions are sometimes confusing, which can lead to potential health risks. If the patients do not speak the language used in the prescriptions, the higher their risks will be.
Level of accuracy
There were several researches made on the accuracy of translations of medicine labels, especially in the Spanish language. Interestingly, Spanish is a dominant language spoken in the United Stated. Currently, around 41 million are native speakers of Spanish while about 11.6 million speak it as a second language. The dominance of the language does not prevent the mistranslation of written text, especially the critical ones such as medicine labels and prescriptions.
In a 2010 PubMed article, the organization published the result of a study regarding the accuracy of computer-generated translation of medicine labels in Spanish. The research was conducted in pharmacies around Bronx, New York where large numbers of Spanish speakers reside. It was found out that the accuracy level of the translation varies, especially with the dosage.
The 316 independent pharmacies included in the survey used 14 programs to translate and print medicine labels in Spanish. The researchers evaluated 76 labels and saw that 32 of them have incomplete translation as they were printed in English and Spanish while another 6 labels had grammatical errors and misspellings.
The researchers found this a glaring issue since the area they survey has a large Spanish-speaking community. Based on their findings they concluded that translations of prescriptions and medicine labels issued by pharmacists would be worse in areas where other immigrant families are situated, particularly if they are speaking languages that are less common.
Effects of mistranslated prescriptions on patients' health
So many documented and undocumented cases of the adverse effects of mistranslated prescriptions proliferate in the healthcare industry. A patient may have received instructions from the doctors in a language he or she does not understand. Likewise, the situation is doubled when the pharmacy fails to provide accurate translation of the prescription because of the computer program they use to translate and print the medicine bottle label.
One such case is that of a man with a heart condition whose prescription stated that his medication should be taken once a day. The English term once, also appears in Spanish. It has the same spelling but has a completely different pronunciation and meaning. It is read as "once" (on-se), which is the Spanish word for the number 11. As the English instruction was retained in the medicine label, the patient mistakenly took 11 pills rather than just one pill per day.
Even the slightest error in the translation can have a grave effect on the health and safety of the patient. In the study mentioned above, the rate of computer translation error (in English-Spanish translation) was 50%. This is not acceptable, considering that New York City has a law that requires pharmacy chains in the city to have labels translated into the top seven languages dominantly spoken in the city, including the Bronx.
Most of the documented cases of mistranslated prescriptions available involve English to Spanish translation.
Another example based on the recollection of Dr. Alejandro Clavier of the Esperanza Health Center located in Little Village, Chicago, is about an anemic patient. The doctor said he was baffled by the patient who does not show any improvement in iron levels even if the patient was faithfully taking the supplements he prescribed. He later found out that the patient was only taking a drop of the supplement each dose instead of the prescribed amount. Apparently, the translated prescription instructions the patient received from the pharmacy was wrong. The doctor said he was no longer surprised because he has been experiencing these types of issues almost every day.
The prescription mistranslations cannot be blamed solely on the pharmacists. Many of them do not speak another language and just rely on the translation program they are using to translate the information from the prescription into medicine labels. There could be spelling errors as well, which can be committed by the person inputting the prescription information. For example, orally is por la boca in Spanish. But an error in typing the letter B can result in por la poca, which means by the little. Mouth in Spanish is boca, while poca means little.
Some phrases, like for 7 days, take with food, apply to affected areas, dropperfuls and apply topically are often not translated or omitted from the label, which could be because the translation program does not have any equivalent words or phrases in Spanish. We all know that most of these computer translation programs are only able to do literal translation.
Sources of the prescription errors
An article published in the National Center for Biotechnology Information (NCBI) website traces the sources of medication errors that may include missed dosages, wrong time intervals, wrong route and wrong dosage forms.
Communication between doctor and patient and patient comprehension are facilitated by the particular content and prescription drug label formats. When these things break down, the patient's life is at risk.
According to the article, about 25% of the errors in medication stem from confusion with the names of drugs. Another 33% are due to confusion in labeling and packaging. Some of the medication errors occur because the patients are not properly administering their prescribed medicine.
Poor labeling is the major cause of errors in medication but this typically comes from the providers and the healthcare systems as well. One of the things the researchers noticed is that the name of the pharmacy and other information useful to the pharmacist are printed prominently in larger fonts and in bigger or colored letters. The medication instruction, the name of the medicine and the warning and other instructions are printed in graduated sizes, with the latter receiving the smallest font.
- The person with the primary responsibility to provide the instruction on the proper way to take the medication is the physician. But according to what the researchers found out, the doctor frequently miss the opportunity to properly counsel their patients on the administration of their prescribed medicine. They often fail to properly communicate and see to it that their patients with limited English language skills understand their health and treatment information.
- Next in line is the pharmacist. Since he or she is dispensing the medicine, the pharmacist should also counsel the patient regarding their medication. However, they also fail in providing the detailed information on how the medicine should be taken.
- The third opportunity is in the medicine label. But in most cases the package inserts, the medication guides, the medication information for the consumer and other sources of information are complex, long and written at a level that is too difficult for an ordinary person (regardless of their literacy level) to understand.
- The lack of regulations and standards is the ultimate reason why prescription errors occur. Contributors include the person giving the prescription and the person who dispenses the medicine.
The information contained in the label of the medicine container comes from the doctor's prescription. The physicians use Latin abbreviations for drug dose and frequency. Doctors as well as pharmacists should have the right training on how to write and transcribe prescriptions.
The label formats from dispensing pharmacies may differ in format but they are relatively the same in presentation. They have the name of the pharmacy and other information advantageous to them printed more prominently that the name of the medicine, the proper dose and the interval of the dose. Often, warning stickers are not included. Moreover, the reading grade level of the information contained in the medicine container is above the high school level of comprehension.
How to protect yourself from mistranslated prescriptions
Even if you are a native English speaker, you may find that you do not fully understand the prescription issued by your doctor. To ensure that your prescription is followed to the letter, you should do the following.
- Even if you sound stupid, ask your doctor about the prescribed medicine and request your doctor to explain the prescription to you.
- If you speak another language, for example Spanish, request a Spanish speaker at the pharmacy to explain the doctor's instructions to you. The pharmacist should double-check that the instructions on the written prescription are the same as the printed instructions to be attached to the medicine container.
- Read and repeat the instructions to the person who dispensed the medicine to ensure that you correctly understood the instructions.
- Call the pharmacy immediately if they have doubts or questions about their filled up prescription.
- This may be far-fetched but it would be beneficial to find a pharmacy where a staff member speaks your language. Or you may look for a pharmacy that subscribes to a translation service provider.
Your health is a major concern. Ensure that you are getting the right treatment and the right medication by asking questions. It's your responsibility to be informed, so you can avoid mistranslated prescriptions.
Avoiding translation errors in medical prescriptions
The health and well-being of patients who do not speak the English language is in the hands of healthcare providers, from nurses to doctors to pharmacists who fill up their prescriptions. There should be safeguards in place in independent pharmacies to ensure that they are printing the medicine labels accurately in any language. Working with a reliable professional translation company is the solution.
Day Translations, Inc. can work with you to establish a system to ensure that the prescriptions and medicine labels are translated and printed according to the doctors' instructions. We can help you translate the prescriptions and labels in any language that is clearly understood by the immigrant population in the United States who do not speak English. Our translators are native speakers and we have experts in the field of medical translation who can work with you anytime. You can reach us anytime, as we are open 24/7, 365 days of the year. You can call us at 1-800-969-6853 or send us an email at Contact us.
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