Prescription Errors and the Use of Regional Language in Drug Labeling

Dr. Mayank Dabral

Introduction

Prescription errors are a significant concern in healthcare, leading to adverse drug reactions, hospitalization, and even fatalities. These errors arise from multiple factors, including illegible handwriting, incorrect drug selection, dosage miscalculation, and communication gaps between healthcare providers and patients. A crucial yet often overlooked aspect of medication safety is the language barrier in drug labeling and prescription instructions. The use of regional languages in drug labeling can improve comprehension, reduce medication errors, and enhance patient adherence, especially in linguistically diverse populations like India.

Understanding Prescription Errors

Prescription errors refer to mistakes occurring in the process of prescribing, transcribing, dispensing, or administering medication. These errors can be classified into several types:

1. Incorrect Drug Selection: A physician may prescribe the wrong drug due to similarities in drug names or lack of patient history.
2. Dosage Errors: Misinterpretation of the correct dose, especially in pediatric or geriatric populations, can result in overdose or subtherapeutic effects.
3. Route of Administration Errors: Misunderstanding whether a drug is for oral, intravenous, or topical use can lead to serious consequences.
4. Illegible Handwriting and Abbreviations: Poorly written prescriptions contribute to dispensing the wrong medication.
5. Language and Communication Barriers: Patients who do not understand the prescribed instructions due to language barriers may misuse the medication.

The Role of Regional Language in Drug Labeling

Many patients, especially in rural areas, are unfamiliar with English or even the official language of their state. Printed drug labels and prescription instructions in English can cause confusion, leading to improper use of medication. Implementing regional language labeling can:

1. Improve Patient Comprehension: Patients can understand the name, dosage, frequency, and route of administration more clearly.
2. Reduce Medication Errors: Clear instructions in a patient’s native language minimize misunderstandings regarding drug use.
3. Enhance Adherence to Treatment: Patients are more likely to follow prescribed medication regimens when they fully understand the instructions.
4. Ensure Informed Decision-Making: Patients can better recognize side effects, contraindications, and precautions when information is available in their language.

Traditional Medicine vs. Allopathy: The Language Divide

While traditional medicine pharmacies often use regional languages in their drug labeling, this practice is largely absent in allopathic medicine. Ayurvedic, Siddha, Unani, and Homeopathic medicines frequently include multilingual labels and dosage instructions tailored to local populations. In contrast, allopathic drug labels are primarily in English, with some including Hindi, but rarely catering to the linguistic diversity of India. This discrepancy makes it easier for patients to understand traditional medicine prescriptions while increasing the risk of misinterpretation in allopathic treatments.

Ironically, we are trying to reach out to the depths of the population using a language understood by hardly 20 percent of the people. The vast majority of rural and semi-urban populations struggle with English-based medical instructions, leading to medication errors that could have been avoided with more accessible language options. It is akin to promoting a drug label in Bengali in Punjab—where neither the prescribing physician nor the patient is likely to understand it. This mismatch between language and audience creates an unnecessary barrier to effective healthcare.

Impact on Patients Seeking Additional Information

Another major drawback of using an unfamiliar language in drug labeling is that it makes it difficult for patients to look up the medicine on the internet to understand its interactions, adverse effects, and contraindications. Most online medical resources provide drug information in English, and if a patient cannot recognize the correct spelling of a medication or its generic name, they are unable to verify essential details like:

Potential drug interactions: Whether the prescribed medicine is safe with other medications they are taking.

Adverse effects: What side effects to watch out for and when to seek medical help.

Dosage adjustments: Whether the medication needs special considerations for age, kidney function, or pregnancy.

Alternative options: If a prescribed medication is unavailable, what substitutes can be used safely?

Without accessible information, patients are entirely dependent on doctors and pharmacists, limiting their ability to make informed decisions about their health.

Challenges in Implementing Regional Language Drug Labeling

Despite its advantages, incorporating regional language in drug labeling poses several challenges:

1. Standardization Issues: India has 22 official languages and hundreds of dialects, making uniform translation difficult.
2. Medical Terminology Translation: Some medical terms do not have direct translations, leading to potential misinterpretation.
3. Regulatory and Logistical Hurdles: Pharmaceutical companies would need to revise packaging, leading to increased costs.
4. Healthcare Provider Adaptation: Pharmacists and physicians may need additional training to ensure proper communication in multiple languages.

Possible Solutions and Future Directions

To overcome these challenges, a multi-pronged approach can be adopted:

Use of Bilingual or Multilingual Labels: Drug packaging can include both English and the dominant regional language.

Standardized Medical Translations: Regulatory bodies like CDSCO can develop official translations for key medical terms.

Technology Integration: Digital prescriptions and QR codes linking to audio/video instructions in regional languages can be introduced.

Public Awareness Campaigns: Educating patients about the importance of reading and understanding drug labels can enhance safety.

Conclusion

Prescription errors pose a serious threat to patient safety, and language barriers significantly contribute to these errors. While traditional medicine pharmacies have embraced regional language labeling, its absence in allopathic medicine creates an additional risk for misinterpretation. We claim to provide healthcare to all, yet we rely on a language that only a fraction of the population understands. It is as impractical as labeling medications in Bengali for patients in Punjab, completely disregarding the linguistic reality of the region.

Furthermore, the lack of familiar language labeling prevents patients from researching their medications online, limiting their understanding of drug interactions, adverse effects, and other critical factors. By integrating regional languages into drug labeling and prescription instructions, healthcare systems can improve medication adherence, reduce errors, and promote patient-centered care. Although challenges exist, technological advancements and regulatory support can facilitate effective implementation, ultimately enhancing public health outcomes.