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On Stay Safe Rx you will find current events and resources advocating for safe prescription labeling practices. When patients struggle to see, read or understand their prescription labels they are more likely to take the wrong medication, take it improperly, or not take it at all. Pharmacies can make prescription labels more accessible by incorporating dual-language, audible, large print, Braille, plain language, and user-friendly designs. Check out the resources in the side bar to assist your own advocacy efforts or browse through posts to see what others are working on or have achieved.

Research and Articles

Accessible Prescription Labeling Standards

US Access Board Best Practices for Accessible Prescription Labeling https://www.access-board.gov/rx.html 

National Culturally and Linguistically Appropriate Standards: https://thinkculturalhealth.hhs.gov/clas/standards  

Statement by the National Association of Boards of Pharmacies: https://nabp.pharmacy/news/news-releases/usp-prescription-container-labeling-chapter-is-now-the-official-standard/

USP Chapter 17 & 1265 Standards for Prescription Labeling: https://www.usp.org/health-quality-safety/usp-nf-general-chapter-prescription-container-labeling 


On Translation (Newer research listed first)

Think Twice about using Google Translate for Patient Counseling and Medication Directions.  Loren Bonner.  Pharmacy Today. February 2022. https://www.pharmacytoday.org/article/S1042-0991(22)00127-X/pdf 

Prescribing in a Pediatric Hospital setting- Lost in Translation? Khayrallah, Al-Saeedy, Medriano, Lee, Sommerfield, Summerfield, Ware, Huppatz, Campbell, Lim, Von Ungern-Sternberger Patient Education and Counseling. October 2021. https://www.sciencedirect.com/science/article/abs/pii/S0738399121006698?via%3Dihub

A Framework for Language Access:  Key Features of US State and Local Language Access Laws and Policies.  Jacob Hofstetter, Margie McHugh, Anna O'Toole.  Migration Policy Institute.  October 2021.  https://www.migrationpolicy.org/sites/default/files/publications/language-access-2021_final.pdf 

Language Barriers and Hospitalized Children: Are We Overlooking the Most Important Risk Factor for Adverse Events? Glenn Flores, MD. JAMA Pediatrics. October 19, 2020 https://jamanetwork.com/journals/jamapediatrics/article-abstract/2771980

Provision of Bilingual Dispensing Labels to Non-Native English Speakers: An Exploratory Study. Helena Herrera, Murtada Alsaif, Ghalib Khan, Nicola Barnes, and Paul Rutter. Pharmacy. 2019. https://www.mdpi.com/2226-4787/7/1/32/htm

Lost in Translation: Medication Labeling for Immigrant Families.  Michelle Cruz Jimenez Smith, H. Shonna Yin, Lee M. Sanders.  JAPhA.  November 2016.  https://www.japha.org/article/S1544-3191(16)30733-6/fulltext 

Development of a Patient -Centered Bilingual Prescription Drug Label. Arun Mohan. Journal of Health Communication. Oct 2013. https://www.tandfonline.com/doi/full/10.1080/10810730.2013.825664

 Rx For Safety:  SafeRx Recommendations for Clear and Accessible Prescription Medication. A Report by Make the Road New York, Center for Popular Democracy and New York Lawyers for Public Interest.  2012  https://nyf.issuelab.org/resources/15046/15046.pdf

Pharmacies May Not Always Translate Prescription Labels for Non-English Speaking Patients.  Laurie Barclay. April 2007. https://www.medscape.com/viewarticle/555840


On Alternative Formats for Visually Impaired or Print Impaired

Medication Errors of Visually Impaired Patients: Before and After Use of ScripTalk.  Issues and Answers Global Marketing Research.  April 2020. https://97805fcd-7ce8-43fa-9088-e5e526583d84.filesusr.com/ugd/99b5c9_b5cfe21f214340d489f9b09a01627139.pdf

Impact of a Talking Prescription Digital Audio Label on Blood Pressure and Self-Efficacy in Low Health Literate Patients with Chronic Hypertension.  Melonia Lillie.  Graceland University. 2019. https://www.doctorsofnursingpractice.org/wp-content/uploads/project_form/complete_290220071404.pdf

A Sticking Point for Medication Adherence: Project with faculty participation has Wisconsin pharmacies re-thinking prescription labels. Katie Gerhards. June 2019.  https://pharmacy.wisc.edu/redesigning-prescription-labels/

Challenges Faced By The Visually Disabled In Use Of Medication, Consequences Of Medication Errors And Their Self-Adopted Coping Strategies At A Tertiary Care Hospital In Goa, India. Naik M, Cacodcar JA, Dhupdale NY. Int J Community Med Public Health. 2018. https://www.ijcmph.com/index.php/ijcmph/article/download/2562/1884

Addressing Low Health Literacy with "Talking Pill Bottles": A pilot study in a community pharmacy setting.   Annie Y. Lam, Juliet K. Nguyen, Jason J. Parks, Donald E. Morisky, Donna L. Berry, Seth E. Wolpin.  JAPhA. 2017. https://www.japha.org/article/S1544-3191(16)30734-8/fulltext

Low Vision = High Risk for Medication Errors.  Katlin Taylor, Dan Sheridan, Melinda Faber. Nursing. 2016.  https://www.nursingcenter.com/wkhlrp/Handlers/articleContent.pdf?key=pdf_00152193-201601000-00017

Adopting an Easy-to-Read Medication Label in Wisconsin. Steven Sparks, David Mott, Henry Young, Sonal Mansukhani, Michele Erikson. 2015. https://wisconsinliteracy.org/file_download/cac0067c-e2bc-42e0-8adf-4a4036ca0cff

A Low-Cost Audio Prescription Labeling System Using RFID for Thai Visually-Impaired People. Titipong Lertwiriyaprapa and Pirapong Fakkheow. Assistive Technology. Winter 2015.   https://pubmed.ncbi.nlm.nih.gov/26427743/

Identifying Solutions to Medication Adherence in the Visually Impaired Elderly.  Miranda Smith.  Trista Bailey. Consult.Pharm. Feb 2014.  https://pubmed.ncbi.nlm.nih.gov/24513423/

US Access Board Best Practices for Accessible Prescription  Drug Labeling. 2013. https://www.access-board.gov/rx.html

Caring for Visually Impaired Patients. Katheleen B. Orrico.  JAPhA. May-June 2013. https://www.japha.org/article/S1544-3191(15)30345-9/fulltext  

Helping Older Adults with Low Vision to be Health Literate. Mary Warren. Visibility. 2012. https://university.envisionus.com/getattachment/282d6006-a039-4e9d-9f06-dd3d4c3467ea/Volume-6-Issue-4.pdf 

The Medicare Prescription Drug, Improvement and Modernization Act of 2003, Section 107(f):  A Study on how to Make Prescription Pharmaceutical Information, Including Drug Labels and Usaga Instructions, Accessible for Blind and Visually Impaired Individuals.  A Report to Congress.  2003.https://www.afb.org/blindness-and-low-vision/your-rights/rx-label-enable-campaign/fda-study-accessible-prescription

An Evaluation of the Functionality and Acceptability of the Voice Prescription Label.  Jian Gao. Journal of Vision Impairment. 2001. https://www.researchgate.net/publication/260298486_An_Evaluation_of_the_Functionality_and_Acceptability_of_the_Voice_Prescription_Label


On Health Equity

Social Determinants of Health, Health Equity and Vision Loss.  Centers for Disease Control and Prevention. 2021. https://www.cdc.gov/visionhealth/determinants/index.html

Disparities in Access to Medical Care for Individuals with Vision Impairment.  Spencer, Frick, Gower, Kempen, Wolff.  Ophthalmic Epidemiology. Sept-Oct 2009. https://pubmed.ncbi.nlm.nih.gov/19874107/  

Role of Independent Versus Chain Pharmacies in Providing Pharmacy Access:  a Nationwide, Individual-level Geographic Information Systems Analysis https://academic.oup.com/healthaffairsscholar/article/1/1/qxad003/7203711