Reading the fine print…

Have you ever had to squint at the tiny print on a prescription label or have to give advice to an elderly family member to interpret their instructions for taking pills? California is in the process of helping to take some of the guesswork–and potential danger–out of deciphering those labels for seniors, people with disabilities, and patients with low English-language proficiency.

California’s Board of Pharmacy held a public hearing on Thursday to consider how to implement a new law that requires patient-centered prescription drug labels. This new law requires the instructions to be in a larger font (type-size), and, upon request from the patient, contain instructions in several other threshold languages for people with low English language proficiency. Here is some of the testimony the Board heard:

  • One consumer advocate described an Asian senior client whose doctor had prescribed low-dose aspirins (81 milligrams) for her heart. Upon returning home and looking at the confusing English-language prescription label, she did not recognize any of the words. The only thing she could read was the number “81.” So she carefully counted out 81 aspirin tablets and took them all that evening. When she was found later by her family, she was rushed to the emergency room for expensive life-saving treatment.
  • Another senior who spoke to the Board through an interpreter described how confused she was by the ten bottles of different medicines that her doctor had been prescribed for her. She had received an oral consultation from the pharmacist, but all she could remember when she got home was that she was supposed to “take one tablet each day.” As a result, because she couldn’t read the prescription label, she lined up the bottles and took one pill from the first bottle on the first day, one pill from the second bottle on the second day, and so on. When she returned to her doctor for follow-up treatment several weeks later, the doctor was puzzled that she had experienced no improvement in her condition. She assured the doctor she had been taking her medicine faithfully, but it eventually took him several more visits to determine why the prescriptions were so ineffective and why there had been such a delay in her treatment.

Having a more patient-centered prescription drug label would have helped in those situations and others described at the hearing by consumers, health professionals, and advocates.

In contrast, the retail pharmacy industry testified that this law was too difficult and expensive to implement. However, several individual pharmacists expressed commitment to assist their patients and a willingness to work with the Board to find solutions regarding container size, the pharmacist’s liability concerns, and other technology/printing issues.

To the Board’s credit, they voted to enter the next formal regulatory step in the process and announced they will schedule another public hearing in January. The Board also hopes to take advantage of special financial and linguistic support offered by a California foundation to translate the most commonly used instructions, such as “take one pill with food” into several non-English languages for general use by pharmacies that operate in the state.

So despite the threats that “all medication will have to be dispensed in mayonaise jars so people can read the labels,” we are hopeful that “help really is on the way.

Health Access California promotes quality, affordable health care for all Californians.
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