Institute of Personality and Social Research, University of California, Berkeley, USA.
Ethn Health. 2011 Apr;16(2):125-44. doi: 10.1080/13557858.2010.543950.
Misunderstanding of prescription labels results in adverse drug events and non-adherence. We assessed the effect of limited English and other factors on prescription understanding among five ethnic groups in a controlled analysis.
Subjects were respondents to California's 2007 Health Interview Survey who received a prescription in the past year. In separate logistic regressions, limited English's effect on self-reported prescription understanding - controlling for bilingual doctor, education level, medications for chronic conditions, disability, years in USA, citizenship and socio-demographics - was estimated for Mexicans, Central Americans, Chinese, Koreans, and Vietnamese.
Unweighted sample size was 48,968. Approximately 14% had limited English and 8% had difficulty in understanding prescriptions. In multivariate analysis, limited English increased odds of difficulty in understanding prescriptions by three times for Mexicans, Central Americans, and Koreans, and four times for Chinese; it was insignificant for Vietnamese. Generally, having a bilingual doctor reduced odds of difficulty while disability, low education, low income or recent immigration increased odds of difficulty. Effects varied according to the ethnic group. In controlled analysis, Chinese and Korean ethnicity increased odds of difficulty compared to Mexican or Central American ethnicity; Vietnamese ethnicity reduced odds of difficulty compared to others.
Limited English blocked prescription understanding for all groups except Vietnamese. Translated prescription labels and interpreted in-person pharmacy consultations are indicated. Education and ethnicity affected prescription understanding; prescription instructions must be compatible with patients' educational level and culture. Bilingual/bicultural providers and interpreters can help bridge linguistic/cultural gaps but efforts should be made to ensure that they are truly culturally and linguistically concordant. Linguistic, cultural or educational needs should be noted in the patient's record or on the prescription to alert pharmacy staff. Sub-populations needing extra support include chronically ill, disabled, recent immigrants, low-income or rural inhabitants. Community outreach workers may provide an effective strategy for assisting these sub-populations with prescriptions.
处方标签的误解会导致药物不良事件和不遵医嘱。我们在一项对照分析中评估了英语水平有限和其他因素对五个族裔群体理解处方的影响。
研究对象为 2007 年加利福尼亚州健康访谈调查的应答者，他们在过去一年中收到了处方。在单独的逻辑回归中，控制双语医生、教育水平、慢性病药物、残疾、在美国的年限、公民身份和社会人口统计学因素后，英语水平有限对自我报告的处方理解的影响——针对墨西哥人、中美洲人、中国人、韩国人和越南人进行了评估。
未加权样本量为 48968 人。约 14%的人英语水平有限，8%的人难以理解处方。在多变量分析中，英语水平有限使墨西哥人、中美洲人和韩国人理解处方困难的几率增加了两倍，使中国人的几率增加了四倍；而对越南人则没有显著影响。一般来说，双语医生会降低理解困难的几率，而残疾、低教育水平、低收入或近期移民则会增加理解困难的几率。这些影响因族裔群体而异。在对照分析中，与墨西哥或中美洲族裔相比，中国和韩国族裔理解处方困难的几率增加；与其他人相比，越南族裔理解处方困难的几率降低。
除越南人外，英语水平有限会阻碍所有人理解处方。建议提供翻译后的处方标签和面对面的药房咨询。教育和族裔影响处方理解；处方说明必须与患者的教育水平和文化相适应。双语/文化双语提供者和口译员可以帮助弥合语言/文化差距，但应努力确保他们真正具有文化和语言上的一致性。应在患者记录或处方上注明语言、文化或教育需求，以提醒药剂师。需要额外支持的亚人群包括慢性病患者、残疾人士、新移民、低收入者或农村居民。社区外展工作者可能是帮助这些亚人群处理处方的有效策略。
