Better serve patients with low health literacy

independent pharmacy blog

Helping low-health-literate and non-English-speaking customers become more adherent

In brief:

  • Millions of Americans have low health literacy and many lack basic English proficiency.
  • When patients aren’t health literate or don’t understand English, they may not understand their medication instructions, which hurts adherence.
  • Two innovative solutions enable pharmacies to provide simple, clear medication instructions in the patient’s own language.
  • When patients receive clear instructions in their own language, they are more adherent. This improves outcomes, pharmacy relationships and revenues, and Star Ratings.

A simple reality: if patients don’t understand their medication instructions, they won’t be as adherent. And if they aren’t adherent, they won’t regularly refill their prescriptions, which affects a patient’s health, a pharmacy’s revenues and a health plan’s Star Ratings.

But simple technology solutions can help pharmacies educate patients and improve adherence.

Two major problems affecting adherence

Millions of American don’t understand their medication instructions. Key factors include:

  1. Low health literacy. Approximately 36% of adults (roughly 90 million Americans) have limited health literacy. About 22% of the population have only “basic” health literacy and another 14% have “below basic” health literacy.1The Institute of Medicine (IOM) defines health literacy as: “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”2The IOM has written, “Consumers rely heavily on the health information that is available to them …. Yet millions of Americans cannot understand or act upon this information.”Sims Preston, the CEO at Polyglot Systems, says traditional medication information provided by pharmacies is often of limited use. This information is typically written at a 12th-grade reading level, is in small font, and is written largely for legal and regulatory purposes. For patients with low health literacy this information is not useful. The result: potentially 1.5 billion prescriptions are dispensed each year to patients who may not know how to properly use them.3
  2. Lack of English proficiency. About 20% of U.S. households (more than 60 million people) speak a language other than English in their home, and among those who don’t speak English at home, 22% do not speak English well or at all. Not speaking English well is more common among individuals over 60 years of age, who take more medications.4 In total, about 8% of the American population has limited English proficiency.5Traditionally, medication instructions provided in U.S. pharmacies have been only in English, creating a barrier to Americans who aren’t proficient in English.However, efforts are underway to address this. There are federal regulations aiming to provide greater protections to individuals with limited English proficiency, and there are state regulations in places like New York and California. These regulations include the written materials pharmacies provide to patients, and may require translation services for non-English speakers.

Solutions for retail pharmacies

Among others, here are two simple, user-friendly, technology-based solutions that can provide multiple benefits for patients and retail pharmacies:

Both solutions provide directions for use (SIGs) for thousands of drugs in over 20 languages, which increases patient understanding and adherence. Other benefits include:

  • Regulatory compliance
  • Improved patient safety and outcomes
  • Increased patient relationships and loyalty
  • Increased revenue from patients who are more likely to refill their prescriptions
  • Increased efficiency by providing personalized instructions at the touch of a button

Patients who don’t speak English well or have low health literacy are a significant segment of the American population. It is important for pharmacies to make sure these patients understand their medication instructions and are adherent. Polyglot/Meducation and RxTran provide pharmacies with simple, user-friendly ways to educate patients in their own language. This can improve adherence and outcomes, increase a pharmacy’s relationships and revenue, and help deliver on key metrics as part of Star Ratings.


1 The Health Literacy of America’s Adults, National Center for Education Statistics
2 Health Literacy: A Prescription to End Confusion, The National Academies Press
3 “Polyglot” website
4 Language Use in the United States: 2011, U.S. Census Bureau
5 The Limited English Proficient Population in the United States, Migration Policy Institute