Patient Counseling
Loren Bonner
Results of a new study about Google Translate for patient medication directions and counseling points should be taken as a warning for pharmacists.
The study, published in the American Journal of Health-System Pharmacy, found inaccuracies and potential for harm of some translations when the app was used for medication directions and counseling points for the top 100 drugs in the United States.
“Although it may be tempting to use alternative means for communicating with patients in another language, the use of certified translators should be used to avoid potential risks associated with translated medication directions and counseling points,” said lead author Bernadette Cornelison, PharmD, assistant clinical professor at the University of Arizona College of Pharmacy.
Researchers specifically looked at translations used for Arabic, Chinese (simplified), and Spanish speakers.
One example of an inaccurate translation included English directions for insulin translated by the native speakers from “take in the evening at bedtime” to “take at night and bedtime.”
“This is a high-risk medication that may cause a hypoglycemic event if taken twice. When back translated by a native speaker, this inaccuracy was not identified as an error as it was recognized as a coherent sentence in Spanish,” said Cornelison.
In the study, 38 unique directions for use and 170 unique counseling points were identified for translation for the top 100 drugs in the United States. For the 38 directions concerning use, 76% of the Arabic translations were accurate, 90% of the Chinese (simplified) translations were accurate, and 71% of the Spanish translations were accurate.
For the 170 counseling points, 54% of the Arabic translations were accurate, 77% of the Chinese (simplified) translations were accurate, and 38% of the Spanish translations were accurate.
Of the 247 inaccurate translations, 29% were classified as highly clinically significant or potentially life-threatening.
Services at pharmacies
Hashim Zaibak, PharmD, owner of Hayat Pharmacy, serves a diverse community in Milwaukee. It’s critical that the pharmacy staff they hire speak different languages. In total, the team at the independent pharmacy speaks 22 different languages.
“If you can hire people who can speak the language, do that,” said Zaibak.
For example, if a pharmacy is located in a Hispanic community, a pharmacist or technician who can speak Spanish is preferable, said Zaibak.
“The challenge is working with smaller minorities,” Zaibak said. “Then sometimes you can rely on Google Translate, even though it’s not the best option. I speak Arabic and I see the translation and it’s not what I meant.”
Instead of using a translation tool, Zaibak goes the extra mile. For instance, he recently saw a patient who speaks only Rohingya, a language spoken by the Rohingya people of Myanmar. One of his pharmacy technicians speaks the language, but he was neither in that day nor reachable by phone when the patient was there at the pharmacy counter.
“But I have a friend who speaks this language,” said Zaibak. “I got him on the phone, and he helped.”
Most retail pharmacies seem to rely on professional interpretation services. A Walgreens spokesperson said their pharmacies, in collaboration with Voyce, provide on-demand voice translation services to patients in all stores across the United States.
“Walgreens team members can conveniently connect patients via Voyce to language interpretation services for 220 languages either during in-person visits or through over the phone consultations,” said Alexandra Brown, a pharmacy communications manager at Walgreens.
A CVS spokesperson said information on prescription labels, such as prescriber instructions and drug warnings, can be provided in 15 other languages upon request.
They also use a language line service to assist patients who do not speak English or who are of limited English proficiency. The language line service offers translation services for over 200 languages.
Consistent findings
Cornelison said their findings are consistent with the few studies that have been previously done on Google Translate for medical applications.
“To our knowledge, this is the first study evaluating the use of Google Translate specifically for the translation of medication directions and counseling points,” she said. ■