In today’s globalised world, pharmacies are serving increasingly diverse communities. It’s not unusual for a single pharmacy to cater to customers who speak a variety of languages, many of whom may have limited proficiency in English. For these individuals, navigating the healthcare system can be intimidating, and one of the most critical areas where this language barrier becomes dangerous is in the handling of prescription medications.
Prescription labels carry essential information—dosage instructions, warnings, storage guidelines, and sometimes even dietary restrictions. When a patient cannot read or understand that information, the risks of misuse increase significantly. Taking the wrong dose, mixing medications that shouldn’t be combined, or missing out on important instructions like “take with food” can all lead to serious health consequences. This isn’t just an inconvenience; it’s a public health concern.
Multi-lingual booklet labels offer a powerful solution to this challenge. By providing medication instructions in a patient’s native language, pharmacies create a much safer and more accessible experience. When patients can clearly understand how and when to take their medicine, they are more likely to adhere to their prescriptions, which improves health outcomes and reduces complications. It also reduces the anxiety many patients feel when dealing with unfamiliar medical instructions.
Pharmacies that adopt multi-lingual labelling show a deep commitment to their communities. It builds trust, particularly with immigrant populations who may already feel alienated by the healthcare system. When people see that their local pharmacy makes an effort to communicate in their language, it sends a strong message: you are seen, heard, and cared for. That level of service strengthens customer loyalty and reinforces the role of the pharmacy as a trusted health partner.
Beyond the personal benefits, there are operational advantages as well. Clear, translated labels help minimise confusion, which means fewer return visits or phone calls to clarify instructions. That saves time for pharmacy staff and ensures that patients are taking their medications correctly the first time. Additionally, as regulations in many regions evolve to emphasise language accessibility in healthcare, pharmacies that offer multi-lingual support are positioning themselves ahead of the curve.
Technology is making this easier than ever. Modern pharmacy management systems often come with built-in translation features, enabling pharmacists to print labels in multiple languages with just a few clicks. With proper implementation and quality control, these systems can help prevent miscommunication and enhance the overall patient experience.
Ultimately, the goal of every pharmacy is to ensure that patients are safe, informed, and supported. Multi-lingual labels are not just about translation—they’re about empowerment. They allow patients to take control of their health, reduce errors, and promote equity in healthcare access. In a world where language diversity is only growing, embracing multi-lingual solutions is no longer optional. It’s essential.
Help for independent pharmacies
Independent pharmacies comprise a shrinking 35% of all retail pharmacies, predominantly serving patients in smaller cities and towns with 50,000 or fewer residents. Just as the retail pharmacy industry has changed in recent decades, these smaller communities are 97% more racially and ethnically diverse than they were in 1980. These demographic changes have increased the diversity of languages spoken in rural and non-metropolitan areas, in addition to the growth of the number of residents.
With a larger population of limited English proficiency (LEP) residents, a few state legislatures have passed laws requiring pharmacies to print prescription labels in languages other than English when requested by the patient. The major potential benefits of such laws are clear: fewer patient medication-related errors and greater adherence to treatment plans due to better understanding of instructions. The latter of which is especially important considering patients with LEP tend to have a lower medication adherence rate than English proficient patients.
New York and California have had multi-lingual prescription label laws on the books for years. In 2020, Oregon enacted its law, SB 698, which requires pharmacies to print labels in 1 of 14 languages in addition to English at the patient’s request, which more than doubles California’s 5 required languages and New York’s 6. Oregon’s required languages include Spanish, Russian, Somali, Arabic, Chinese (Simplified), Vietnamese, Farsi, Korean, Romanian, Swahili, Burmese, Nepali, Amharic, and Pashto.
Multi-lingual prescription label laws still raise the question as to why 6 or 14 languages are in use considering there are more than 350 languages spoken in households across the United States? Most pharmacies only need a few languages representing their local community, but those languages vary by location across the country and the less common languages represent a more difficult resource issue for many pharmacies. The capability to generate labels and patient education materials in a wider range of languages can cost-effectively attract and retain more patients to independent pharmacies, distinguishing them in their communities while increasing customer loyalty.
While the labelling laws in New York, California, and Oregon are newer state laws, pharmacies in other states are also obligated to provide language services to LEP customers. Existing federal rules (EO 13166) already require meaningful access for persons with LEP based on enforcement of Title VI of the Civil Rights Act of 1964 “National Origin Discrimination Against Persons with Limited English Proficiency.” These rules are enforced by the Office of Civil Rights.
However, state labelling laws similar to Oregon’s add specificity for pharmacies, as determined by their state boards of pharmacy, as opposed to the broader federal requirements. Oregon’s law, for example, requires pharmacies to post signs informing patients with LEP that they are entitled to free, competent oral interpretation and translation services.
In many smaller communities, prescribers and pharmacists usually rely on available bilingual staff, oral interpretation services, such as telephone interpreters, or family members to educate patients, but often do not provide written translation instructions for their medications. Oral instructions are more easily forgotten or misremembered, leading to potential medication-related errors and patient harm.
A study of Hispanic parents with LEP and limited health literacy indicated that they were more than twice as likely to make mistakes dosing liquid medications for their children. Likewise, patients with LEP had lower medication-related self-efficacy scores than patients with greater English proficiency, which may put them at greater risk for medication errors and lower adherence.
Expanding care access and loyalty
In 2019, there were 21,683 independent community pharmacies, down from 22,478 in 2014. Likewise, the average prescription volume was 57,414 per store in 2019, declining more than 1000 prescriptions since 2018.
Sustaining independent pharmacies in large and small communities will require these businesses to change based on how the market evolves. If their communities are becoming diverse, they should not wait for a new law requiring them to print labels in the languages representing their community.
Rather, independent pharmacies should be proactive and modernise their operations in anticipation of these changes to offer superior pharmaceutical care in their communities compared to their competitors, encouraging patient satisfaction and loyalty. Alliances representing community pharmacies, such as the National Community Pharmacists Association, can leverage their collective voices to push vendors for more consumer-friendly features.
By translating labels and education materials, pharmacies can, more importantly, improve their patients’ understanding of their prescription, including dosing and regimen schedules.
Implementing such changes does not need to be difficult, which has been proven in a 2015 survey which looks at New York City pharmacies.12 Reliable translated content solutions that can be easily integrated with pharmacy management systems have emerged to make it easier and faster for independent pharmacies to not only comply with state and federal requirements but also to go beyond the law to better serve their patients and the community.
Dutch supermarkets
Top executives from major Dutch supermarket chains have called for an end to the requirement that product labels be in Dutch. They argue that this move would help supermarkets better cope with rising procurement costs, particularly from A-brands. The proposal, which was voiced by the leaders of PLUS, Jumbo, and Picnic, advocates for uniform labelling across the European Union.
Under current regulations, manufacturers are required to include Dutch-language information on product packaging sold in the Netherlands. However, Aart van Haren, CEO of PLUS, pointed out that other EU countries impose less stringent labelling requirements.
“I can imagine that, as a legislator, you might say there should be an English-language label, and the supplier could include a QR code that links consumers to a website with all the languages,” he said Thursday evening during a roundtable discussion in Oegstgeest, Zuid-Holland. The discussion focused on ongoing negotiation difficulties with suppliers.
Malik Azmani, a Member of the European Parliament from the VVD party, expressed interest in discussing these proposals in the European Parliament. However, he cautioned that any new legislation could take one to two years to pass. “We are still at the very beginning stages,” he added.
Ton van Veen, the departing CEO of Jumbo, and Joris Beckers, co-founder of Picnic, also supported the idea, saying it could help resolve the ongoing price disputes with manufacturers. The supermarket executives claim that multi-language labels are a factor contributing to price discrepancies across different countries. They suggest that A-brands may charge higher prices to Dutch supermarkets than to their counterparts in other EU nations.
The supermarket leaders are also calling for the European Union to ban manufacturers from refusing to supply products to supermarkets outside of the Netherlands. Van Veen explained that large companies like Coca-Cola in Germany can refuse to supply supermarkets if they are not already a customer. “Look objectively at what retailers earn. At the end of the day, it’s much less than what A-brands earn. The big players make 20 to 25 percent, and we only make 3 to 4 percent,” he said, referring to supermarket chain profit margins.
Digitising pharmacy
Pharmacies across London are benefitting from the support of Written Medicine; a service providing bilingual dispensing labels in patients’ language of choice.
Founded in 2012, Written Medicine’s software is used by pharmacies and hospitals to translate and print medication information, instructions and warnings. Drawn from a dataset of 3,500 phrases, printed labels are available in fifteen different languages. The bi-lingual labels are supporting patients to take ownership of their treatment; giving them a better understanding of how to take their prescribed medication. The solution is helping to reduce errors, improve medication adherence and enhance patient safety and experience.
London North West University Healthcare NHS Trust (LNWH) has been using Written Medicine since 2016, starting from their outpatient pharmacy in Ealing Hospital. The Trust serves an ethnically and linguistically diverse demographic across North West London, which requires interpreting services in over 40 languages, mostly from South Asia, Middle East and Eastern Europe.
An audit to assess the quality and impact of the bilingual labelling service at LNWH report in 2019 stated, “post-service questionnaire revealed all patients would like the continuation of the service by their community pharmacies demonstrating the impact it has had in patient empowerment and adherence.”. Written Medicine is now used across all three hospitals in LNWH, at the point of dispensing in outpatient pharmacy and integrated into the discharge system.
Poureya Aghakhani, Principal Pharmacist at Ealing Hospital, part of LNWH said, “Patients who are unable to speak English are less likely to understand their doctors, pharmacists and written instructions. This can stop them from taking their medication or may result in them taking it in an unhelpful or dangerous way.
“Giving patients information in a language they understand increases awareness around how and when medication should be taken. It empowers individuals to take ownership of their treatment, improving how they manage their conditions and reduces their risk of harm. It can also have a positive financial impact in terms of unused medications and avoidable hospital admissions.”
The software is available via a cloud-based platform and used across healthcare settings at the point of prescribing, dispensing and discharge. It can also be integrated into existing information technology.
