Lost in Translation? Drug Label Translation Proposal Presents Problems for Patients, Pharmacists

Proposal would require California pharmacists to dispense medications with labels translated into languages they cannot read.

In California, pharmacists and patients face a catch-22: patients who cannot understand English say they cannot read the labels on their medications, and that translating the labels would help them. The act of translation, however, would create a situation in which pharmacists are dispensing medications that they cannot verify because they do not know the language in which the labels are written.

The California Board of Pharmacy will consider whether drug labels should be translated into a language the patient understands at its July 31, 2014, meeting.

Jon R. Roth, CAE, chief executive officer for the California Pharmacists Association, said the proposed rule presents serious legal liabilities for pharmacists—particularly if they cannot understand the language in either spoken or written form.

“Pharmacists, of course, want to provide the highest level of patient-centered care in as culturally-competent [a] manner as possible,” Roth said in an e-mail to Pharmacy Times. “However, the pharmacist is the last licensed professional that the patient will interact with before they begin their medications. By mandating that a pharmacist dispense a medication with a label that the pharmacist can neither read nor write, we believe is the equivalent of malpractice, and the pharmacist’s personal responsibility and professional license are on the line for an error that could occur with the directions on the translated container.”

The California Board of Pharmacy requires no-cost oral translation of both prescription labels and instructions offered by either a call-in hotline or by pharmacy staff. Pharmacists in the state have also been required to display a poster informing patients of their right to no-cost translations, as well as a series of phrases to which patients can point to alert the pharmacist of a need for translation.

According to the Fresno Bee, the board itself is required to provide written translations of basic instructions in Spanish, Korean, Russian, Chinese, and Vietnamese.

Dispensing translated labels makes California pharmacists uncomfortable, particularly because the pharmacist would be legally liable for any mistake on the translated label, Roth told the Fresno Bee.

Still, public health advocates in the state say that the changes are overdue, and the explanations provided do not go far enough.

Roth says translating the label only covers a small portion of medication therapy, and does not cover some of the truly important information about correct medication use.

“Ensuring safe, quality medication use is not just about reading the label; it is ensuring that patients understand everything about that medication, such as side effects and what to look for in an adverse reaction,” Roth said. “That information isn’t on a label, but is equal, if not more important, than what is on the label. Engaging the patient in a conversation about their medicines using an interpreter is the most important characteristic for ensuring they will take the medication correctly.”