title: Evaluation of language concordant, patient-centered drug label instructions.
abstract: BACKGROUND
  Despite federal laws requiring language access in healthcare settings, most US pharmacies are unable to provide prescription (Rx) medication instructions to limited English proficient (LEP) patients in their native language.
  
  
  OBJECTIVE
  To evaluate the efficacy of health literacy-informed, multilingual Rx instructions (the ConcordantRx instructions) to improve Rx understanding, regimen dosing and regimen consolidation in comparison to standard, language-concordant Rx instructions.
  
  
  METHODS
  Randomized, experimental evaluation.
  
  
  METHODS
  Two hundred and two LEP adults speaking five non-English languages (Chinese, Korean, Russian, Spanish, Vietnamese), recruited from nine clinics and community organizations in San Francisco and Chicago.
  
  
  METHODS
  Subjects were randomized to review Rx bottles with either ConcordantRx or standard instructions.
  
  
  METHODS
  Proper demonstration of common prescription label instructions for single and multi-drug medication regimens. Regimen consolidation was assessed by determining how many times per day subjects would take medicine for a multi-drug regimen.
  
  
  RESULTS
  Subjects receiving the ConcordantRx instructions demonstrated significantly greater Rx understanding, regimen dosing and regimen consolidation in comparison to those receiving standard instructions (incidence rate ratio [IRR]: 1.25, 95 % confidence interval [CI]: 1.06-1.48; P= 0.007 for Rx understanding, IRR: 1.19, 95 % CI: 1.03-1.39; P= 0.02 for regimen dosing and IRR: 0.76, 95 % CI: 0.64-0.90; P= 0.001 for regimen consolidation). In most cases, instruction type was the sole, independent predictor of outcomes in multivariate models controlling for relevant covariates.
  
  
  CONCLUSIONS
  There is a need for standardized, multilingual Rx instructions that can be implemented in pharmacy practices to promote safe medication use among LEP patients. The ConcordantRx instructions represent an important step towards achieving this goal.
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, 750 N Lake Shore Drive, 10th Floor, Chicago, IL 60611, USA. stacy-bailey@northwestern.edu
authors.forename: Stacy Cooper
authors.initials: SC
authors.lastname: Bailey
authors.forename: Urmimala
authors.initials: U
authors.lastname: Sarkar
authors.forename: Alice Hm
authors.initials: AH
authors.lastname: Chen
authors.forename: Dean
authors.initials: D
authors.lastname: Schillinger
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003144:Communication Barriers; D032882:Comprehension; D016001:Confidence Intervals; D004348:Drug Labeling; D004522:Educational Status; D005006:Ethnicity; D005069:Evaluation Studies as Topic; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D008875:Middle Aged; D019303:Multilingualism; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000379:methods*; D055553:Prescription Drugs; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D055553:Prescription Drugs