Health literacy and pharmacists: The need is clear

More can be done, but resources are limited

Soojin Jun’s desire to become a pharmacist stemmed from personal experience taking care of her dying father, a Korean immigrant.

Jun, PharmD, now a pharmacist at Aurora Healthcare in Wisconsin, was her father’s primary caretaker during his long battle with esophageal cancer. He was also diagnosed with diabetes and was left with a complicated medication regimen that needed to be managed closely. A second, consecutive hypoglycemic episode landed him in the hospital, where he died suddenly.

Jun said she felt a lack of understanding from his providers throughout the illness. She enrolled in pharmacy school a couple of years after his death. To this day, she’s felt a personal responsibility to push for more health literacy in the pharmacy profession, and not just for patients with limited English proficiency. “In hindsight, all we needed was comprehensive education from a [diabetes] educator—and this could have been a pharmacist,” Jun told Pharmacy Today.

From foreign languages to cultural sensitivity

Health literacy for pharmacists encompasses language, as well as medication therapy management (MTM) and cultural sensitivity. To date, only pharmacies in New York are required to provide both written and oral instructions to patients in certain foreign languages upon request. California is working on implementing similar legislation.

Sandra Leal, PharmD, MPH, decided on a career in pharmacy partly because she noticed a lack of Spanish-speaking providers in her community.

“When people aren’t able to ask questions in their own language, or there’s a lack of trust, that can definitely lead to potential medication errors,” said Leal, who is Vice President for Innovation at SinfoniaRx in Tucson, AZ.

Translation services for MTM

University of Florida Medication Therapy Management Communication and Care Center (MTMCCC) has a mission to improve MTM, medication adherence, and CMS star ratings for Medicare plans. One of MTMCCC’s service offerings is a telephonic adherence intervention. The more than 70 full-time staff go through a robust cultural competency training program, too.

While it’s handy to have bilingual employees—which MTMCCC is always looking for—staff members at MTMCC have access to a language line, like many telephonic MTM services do.

“Luckily in our intervention, it’s all telephonic so we can easily access a language line,” said Karen McLin, PharmD, Director of MTMCCC.

Financial barriers remain

However, most community pharmacies don’t have access to translation services, mostly because of financial barriers.

Some community pharmacies provide customized prescription labels in up to 15 languages, if needed. Walgreens has a website feature that enables patients to search for bilingual pharmacists at certain locations to consult with them in their preferred language.

A CVS Health spokesperson told Today that its pharmacies offer telephonic language interpretation services in more than 150 languages.

Charles Lee, MD, President and Founder of Polyglot Systems, which provides cost-efficient translation software to pharmacies and hospitals, told Today that the main advantages of translation technologies are scalability, automation, and the option of written instructions that can be tailored to each person.

Evolving pharmacy curriculum

“In the past 10 years, health literacy has become an integral part of the curriculum both in pharmacy schools and medical schools,” said Ann Zweber, BSPharm, Senior Instructor at Oregon State University College of Pharmacy.

Not only is health literacy an accreditation requirement, but the American Association of Colleges of Pharmacy’s new Center for Advancement of Pharmacy Education (CAPE) included cultural sensitivity as one of the subdomains under its Educational Outcomes 2013, which are intended to be the target of the evolving pharmacy curriculum.

In addition, the Accreditation Council for Pharmacy Education adopted the CAPE 2013 Educational Outcomes as part of Standards 2016. AACP said cultural sensitivity is now part of the larger domain of approach to practice and care.