Tag Archive | language

Community pharmacists’ use of language access services

One of my pet interests is health literacy and its far-reaching impact on quality and access to healthcare.  The issues surrounding it can almost be insidious in nature.  Despite this, health literacy is typically only given superficial coverage in traditional training programs. 

Here in South Florida we have an especially diverse patient population with a higher than average percentage of those with limited English proficiency (LEP).  It’s pretty intuitive, but LEP patients are (unfortunately) more likely to encounter barriers to health care and are associated with poorer outcomes than non-LEP patients. 

In part to address this, there was actually an Executive Order mandating “meaningful access” be given to LEP persons for Federally-funded activities (what, you didn’t think ‘meaningful use/access’ was limited to EHRs and the like?).  Consequently, hospitals, clinics, etc. began incorporating translators and other language access services (LAS) as SOP (at least on paper) due to their receipt of Federal funding/payments.  However, a funny thing happened on the way to implementation in community pharmacies – much as those pharmacies and the healthcare professionals that staff them are treated differently than similar entities/professionals in our system of health care…this mandate has been treated more as a voluntary compliance issue.  What, if any, impact has this had on reimbursement or outcomes?  The jury is still out.  However, as a first step to methodically examine this issue, we conducted a national survey of availability and use of LAS in community pharmacies; the initial results of which have recently been published in the Journal of the American Pharmacists Association (JAPhA).

Pharmacist responses to the survey ranged from descriptions of widely advertised and seamlessly integrated interpretation (verbal) and translation (written) LAS services to the (rarely observed) attitude of ‘if they’re in our country they should speak English’.  Overall, we identified issues regarding awareness (e.g., about half of pharmacies with LAS capacities did not report making them known to patients), use of LAS (e.g., about 40% said they “never” used interpretation/translation tools), and workflow/time (e.g., a quarter of respondents said they simply lacked time to use LAS).  Alternately, there were encouraging signs as pharmacies that did apprise patients of LAS availability used a variety of methods including in-store direct notification, signage, flyers, and targeted mailings.  Additionally, more LAS products are becoming available such as Elsevier’s MEDcounselor Languages module, which advertises SIG translation and patient education materials in 14 languages.  Another gem that area pharmacists have started using (albeit moreso in AmCare clinic settings) is the free MediBabble iPhone app.  My understanding is that a future update will (ahem) include pharmacists in the introductions section. 

Unfortunately, our article “Community pharmacists’ use of language-access services in the United States” is behind a subscription wall, but I would be happy to answer any questions that I can.

@kevinclauson

Disclosure: A couple years ago we received a grant from one of the quadrillion companies Elsevier operates for an unrelated research study.  Inclusion of their product in this post is mostly due to timing (I just received an email about it), and should probably not be construed as a conflict of interest except for the most Mel Gibsonian of conspiracy theorists.  Separately, this JAPhA LAS study was funded by a NSU President’s Grant.  Going forward we are planning to study the LAS disconnect further, as well as possible solutions that may include tools such as automated LAS kiosks in pharmacies and online functionality as well as LAS availability notification via social media; funding source(s) TBD.

 

Source: Feichtl MM, Clauson KA, Alkhateeb FM, Jamass DS, Polen HH. Community pharmacists’ use of language-access services in the United States. J Am Pharm Assoc. 2011;51(3):368-72.

Soapbox 2.0: Use of blogs by pharmacists

I saw a tweet by John @Poikonen that alerted me to the fact that a second article in as many weeks has been published on pharmacy and blogs.  Two pharmacy students (Justin Elkins and Chilla Goncz) and I authored “Use of blogs by pharmacists“, which appears in the new issue of the American Journal of Health System Pharmacy.  We identified all blogs that were pharmacist-authored, active (i.e. posts in the last 3 months), and written in English.  Blogs focused on pharmacy, but not written by a pharmacist were excluded.  Forty-four blogs were identified that fit those criteria.  We used the most recent 5 posts to assess the blogs based on six categories (e.g. practice based topics, identifying information, positive language, critical language, professionalism and miscellaneous). 

Most pharmacist blogs (68%) were written anonymously (versus 43% in Lagu’s study of physician and nurse blogs).  Pharmacist bloggers were equally represented by community (43%) and non-community settings (43%); the practice settings of the remainder were indeterminable.  These blogs most commonly used positive language to describe the profession (32%), other health care professionals (25%), and patients (25%).  Critical language was more commonly observed in descriptions of patients (57%); almost half of all posts contained profane or explicit language (48%). 

Most of the blogs (71%) contained mentions of pharmacologic therapies and current healthcare events (66%).  We also noted that 25% of these bloggers had a Twitter account (relative to 11% of the general population in the same timeframe per Pew).  Out of the 11 pharmacist blogs that were ranked by Technorati, all but two were primarily of a ‘ranting’ nature (e.g. Angry Pharmacist, Angriest Pharmacist, Your Pharmacist May Hate You).  Interestingly, the only two ranked, but non-ranting blogs were written by non-US pharmacists. 

Our full AJHP article lists all of the 44 blogs and while it is not open access, my hope is that via ASHP Connect and rapid response that this list of pharmacist blogs can be updated and curated using our article as a starting point.   

@kevinclauson

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