Pharmacy-related health disparities experienced by non-english-speaking patients: impact of pharmaceutical care.

OBJECTIVES

To identify the availability of foreign language services in pharmacies near a medical clinic serving a large immigrant population and determine whether the type of observed drug therapy problems differed between English- and non-English-speaking patients at this clinic.

SETTING

A community health care center in a diverse neighborhood of Minneapolis, Minnesota.

PARTICIPANTS

40 pharmacies near the clinic and in the surrounding Minneapolis-St. Paul area known to provide services to patients in languages in addition to English and 91 clinic patients, including 38 for whom English was not their primary language, seen for full pharmaceutical care assessments.

INTERVENTIONS

Comprehensive drug therapy assessments were conducted for English- and non-English-speaking patients (with assistance from interpreters) in a primary care setting secondary to physician referral. Patient-specific data and the results of the pharmacist's assessment were recorded in a patient management database.

MAIN OUTCOME MEASURES

Language services provided by area pharmacies, frequency of drug therapy problems in English- and non-English-speaking patients, and the status of patient's medication conditions before and after provision of pharmaceutical care.

RESULTS

Of the six primary languages other than English (Vietnamese, Hmong, Laotian, Somali, Spanish, and Cambodian) spoken by clinic patients, written or verbal information was available for five languages in one or more area pharmacies. The clinic pharmacist completed comprehensive assessments for 91 patients via 230 patient encounters, identifying 186 drug therapy problems. Problems related to adherence were significantly more prevalent in non-English-speaking patients compared with English-speaking patients (31% versus 12%). In all 91 patients, the percentage achieving desired drug therapy outcomes improved by 24% after a pharmacist joined the team of clinic providers.

CONCLUSION

Despite the availability of clinic-based interpreters and foreign language services in pharmacies, adherence-related problems are significantly more common in non-English-speaking patients. Pharmacists committed to providing pharmaceutical care must consider the impact of language barriers when working to optimize drug therapy outcomes.