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Patients at risk due to lack of translations

Patients at risk due to lack of translations (medical translation)Last week, we wrote how 50% of translated Spanish medicine labels contain errors. The article was based on a recently released study that highlighted the dire state of machine translated prescriptions in New York City pharmacies.

As if that study wasn't troubling enough, a different study shows that the problem goes beyond New York City and further than machine translation.

The Unnatural Language Processing blog reported on a recent article in The Oncology Pharmacist. Pharmacists Underuse Language Assistance Services discussed the findings of questionnaires completed by 296 chain and independent community pharmacists nationwide.

What emerges is a picture of pharmacists believing that you are "damned if you do, damned if you don't" provide language assistance services (LAS). For instance, the article states that respondents were hesitant to provide translated information:

"More than half of pharmacists who did not use LAS said their hesitation stemmed from concern about inaccuracies in translation/interpretation."
Even more disconcerting is the fact that roughly 25% of respondents said that they were worried about legal issues.
"Pharmacists said they were worried that they would be liable if the prescription label was printed in a language they did not know and included inaccurate translations"
Whatever the concerns, the fact is that almost half of pharmacists who have LAS fail to notify their patients of its availability.

But the decision not to provide translated information is also putting patients at risk. The article mentions the following case:
"... a pharmacist tried to explain to the Spanish-speaking parents of a 10-month-old girl how to give the prescribed dose of an iron supplement by showing them the dropper and vial. The pharmacist did not speak Spanish, and an interpreter was not used. Although the parents nodded that they understood the pharmacist's directions, instead of using the dropper, they gave a tablespoon of iron to the infant. As a result, the child received a 12.5-fold overdose and had to be hospitalized."
The study's lead author (and publisher of the Unnatural Language Processing blog) prepared the following excellent summary of their findings:

Language assistance services: a national survey of community pharmacies
[click on the image for a larger PDF version]

So, how do you bridge the culture and language gap when providing professional translations is too expensive, providing qualified interpreters is unrealistic, and vastly improved machine translation output is still in the far-off future?

It seems that more training for pharmacists is required. Unless these front-line health care professionals understand the underlying language and cultural issues, they cannot begin to bridge the gap. Tools like LAS kiosks, community outreach, and social media can also play a role in helping patients understand the availability - and limitations - of translated information.

[Tip of the hat to Kirti Vashee!]

ForeignExchange Translations provides specialized medical translation and software localization services to drug and device companies. Contact us to learn more.


  1. Andrew Bell said...
    Great article as usual guys - well done!
    Anthony said...
    Kind of scary news but it shows well how important translation is in our would.
    Amelia said...

    We all need to be aware of such delicate matters.

    Another important topic in this field is the use of plain English in all information addressed to patients.

    We have written about this:


    Best regards,


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