Label Me Spanish: Spanish Directions for Use

Event Type Live Online ACPE Expiration Date 11/17/2014 Credits 1 Contact Hour Target Audience Nurses, Pharmacists, Pharmacy Technicians Program Overview One of the most important functions of a pharmacy is to be sure its patients fully understand their prescription directions to increase the likelihood that they will follow them and to decrease the instance of misuse or overdose. This is a tall enough order with English speaker. When we consider that even those Spanish speakers who understand some English may not be able to read it, this task becomes daunting to those pharmacy professionals who don't have a working knowledge of Spanish. "Label Me Spanish" is a sequel to "An Introduction to Pharmacy Spanish". This program will focus on putting together directions for medication use in Spanish. Nurse Educational Objectives Identify the correct pronunciation for each vowel in Spanish Explain why the order of a Spanish speaker's full name can cause labeling and filing errors Describe general consumer habits of Spanish speakers Identify common errors in labeling made by computer-generated Spanish translations Give accurate and complete directions for use in Spanish Pharmacist Educational Objectives Identify and practice the correct pronunciation for each vowel in Spanish Explain why the order of a Spanish speaker's full name can cause labeling and filing errors Describe general consumer habits of Spanish speakers Identify common errors in labeling made by computer-generated Spanish translations Give accurate and complete directions for use in Spanish

Pharmacy Technician Educational Objectives Identify sounds that are most different between English and Spanish Translate simple directions for use in Spanish Activity Type Knowledge Accreditation Nurse Pharmacist Pharmacy Technician N-685 0798-0000-11-055-L04-P 0798-0000-11-055-L04-T PharmCon, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. PharmCon, Inc. has been approved as a provider of continuing education for nurses by the Maryland Nurses Association which is accredited as an approver of continuing education in nursing by the American Nurses Credentialing Center s Commission on Accreditation. Faculty Stephanie Langston, MFLE Owner, Hands on Spanish Financial Support Received From Pharmaceutical Education Consultants, Inc. Disclaimer PharmCon, Inc. does not view the existence of relationships as an implication of bias or that the value of the material is decreased. The content of the activity was planned to be balanced and objective. Occasionally, authors may express opinions that represent their own viewpoint. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient or pharmacy management. Conclusions drawn by participants should be derived from objective analysis of scientific data presented from this activity and other unrelated sources.

"Label Me Spanish" Spanish Directions for Use presented by: Stephanie Langston Hands on Spanish, Inc. This program has been supported by PharmCon Label Me Spanish Spanish Directions for Use Accreditation: Pharmacists: 0798-0000-11-055-L04-P Pharmacy Technicians: 0798-0000-11-055-L04-T Nurses: N-685 CE Credits: 1 contact hour Target Audience: Pharmacists Technicians & Nurses Program Overview: One of the most important functions of a pharmacy is to be sure its patients fully understand their prescription directions to increase the likelihood that they will follow them and to decrease the instance of misuse or overdose. This is a tall enough order with an English speaker. When we consider that even those Spanish speakers who understand some English may not be able to read it, this task becomes daunting to those pharmacy professionals who don t have a working knowledge of Spanish. Label Me Spanish is a sequel to An Introduction to Pharmacy Spanish. This program will focus on putting together directions for medication use in Spanish Objectives: Identify and practice the correct pronunciation for each vowel in Spanish Explain why the order of a Spanish speaker s full name can cause labeling and filing errors Describe general consumer habits of Spanish speakers Identify common errors in labeling made by computer-generated Spanish translations Give accurate and complete directions for use in Spanish PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity. This program has been supported by PharmCon Label Me Spanish Spanish Directions for Use Speaker: Stephanie Langston, MFLE, is a Spanish teaching professional and entrepreneur. She is the President, Curriculum Director and Lead Instructor of Hands on Spanish, Inc. (www.handsonspanish.com) and is a College Spanish Instructor. Her company s programs include Pharmacy Spanish (approved for 12 hours of ACPE credit), Court Spanish (a CE course for legal professionals), Webspanol (an online conversational tutorial) and Uno, Dos, Tres (A Spanish program for children). All of the programs except Court Spanish are offered online at www.handsonspanish.com in multi-media format with video instruction, mp3 audio files, audio CDs and DVDs. She also led the development of 400 hours of Spanish curriculum customized for the Immigration and Customs Enforcements Agents for the Department of Homeland Security. New agents must take and pass the Spanish course in order to proceed with their training. She lives in Monroe, GA with her husband Chris, and her son, Emery. They are active in their church, are avid travelers and are looking forward to a return journey to Colombia to adopt their second child. Speaker Disclosure: Mrs. Langston has no conflict of interest with any of the corporations providing financial support for this continuing education activity. This program has been supported by PharmCon Learning Objectives 1. Identify and practice the correct pronunciation for each vowel in Spanish. 2. Explain why the order of a Spanish speaker's full name can cause labeling and filing errors. 3. Describe general consumer habits of Spanish speakers. 4. Identify common errors in labeling made by computergenerated Spanish translations. 5. Give accurate and complete directions for use in Spanish. PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.

Hispanic Demographic Statistics How much do you know about the U.S. Hispanic Growth? You can find these and more statistics at www.census.gov. Hispanic Demographic Statistics About 45 million Hispanics currently live in the U.S. Hispanics are the nation s largest minority group. The estimated annual buying power of the U.S. Hispanic market is 600 billion. The U.S. has the third largest Hispanic population in the world. There are more Spanish speakers in the U.S. than in Spain. Better Serve Your Pharmacy and Your Patients with Job-Specific Spanish Decrease errors in labeling and filing. Improve customer relations. Increase customer base. General Consumer Habits of Spanish Speakers Hispanic customers are more loyal to merchants and spend 46% more than the general population. * They are more likely to generate word-of-mouth referrals and to persuade others away from stores where they are not treated well and are more passionate in their relationships with brands.** * Food Marketing Institute Nonprofit Organization www.fmi.org **Ipsos Study Compares Differences in Opinions about Customer Service and Word of Mouth Between Hispanic and Non-Hispanic Households www.ipsos-na.com

Filing Errors Cómo se llama usted? The Spanish naming system Let's first focus on filing errors. These occur frequently with Hispanics because they typically have two surnames ("last" names). Ella se llama María Teresa Álvarez González. María Teresa Álvarez González primer nombre Cómo se llama usted? The Spanish naming system segundo nombre apellido paterno apellido materno OR apellido del esposo Cuál es su...(fill in with name needed)? What is your... Cómo se llama usted? The Spanish naming system According to tradition, her name would become... María Teresa Álvarez Montalvo. Juan Carlos Montalvo Garzón. Cuál es su nombre completo? What is your full name?

Cómo se llama usted? The Spanish naming system If they have a child... Madre: María Teresa Álvarez Montalvo. Padre: Juan Carlos Montalvo Garzón. Hija: Isabel Carolina Montalvo Álvarez. Hispanic Names English What is your full name? Write it down, please. What name do you go by? What are your last names (if you want both the one they say first is the one you will file them under)? Spanish Cuál es su nombre completo? Escríbalo, por favor. Qué nombre usa diariamente? Cuáles son sus apellidos? Is your name spelled correctly here? Es correcto el deletreo de su nombre y sus apellidos aquí? Is this how you d like your name to appear? Is this correct? Here are some phrases in Spanish that will assist you in obtaining the patient's correct name, whether for a new patient or for the purposes of cross-checking an existing patient in the system. Repeat each after me. Es como quiere usted que su nombre completo aparezca? Es correcto? Example: Your patient's complete name (as given to you by her) is: Elena Teresa Camarillo Ochoa She would be filed under... Problems Encountered by Spanish Speakers in Taking Prescription Medications One of the most important functions of a pharmacy is to be sure its patients fully understand their prescription directions to increase the likelihood that they will follow them and to decrease the instance of misuse or overdose. This is a tall enough order with English speakers. When we consider that even those Spanish speakers who understand some English may not be able to read it, this task becomes daunting to those pharmacy professionals who don't have a working knowledge of Spanish.

Problems Encountered by Spanish Speakers in Taking Prescription Medications In a recent survey, over half of the Spanish-speaking respondents found it "impossible" to fully understand their prescription drugs because of language difficulties. 44% of Spanish-speaking participants said they have at one time taken the wrong dosage because they had trouble translating the instructions into Spanish. Overall, 17% have performed an activity that they shouldn't have while on their medication. Problems Encountered by Spanish Speakers in Taking Prescription Medications 28% of those overall surveyed have guessed at the proper dosage to take because they weren't sure what it said. 33% of all respondents surveyed have left the doctor's office without being fully clear about their medication. http://www.transperfect.com http://www.transperfect.com Common Errors in Labeling Some pharmacy professionals may utilize an English-Spanish dictionary to assist in translations. A dictionary is helpful for intermediate to advanced speakers of a language, but it can be quite dangerous for a beginner due to lack of understanding of parts of speech and verb conjugations. Example: "I work at CVS." can yield "Yo obra de arte a CVS." Literal translation: I work of art at CVS. OR "Yo funciono a CVS." Translation: "I operate/function at CVS." Translation websites (like Babblefish) cannot take into account the context of a sentence and can sometimes yield highly awkward and sometimes incomprehensible translations. Example: "until gone" yields "hasta el pasado" (literal translation: until the past) Common Errors in Labeling Many pharmacy professionals make use of computer-generated Spanish label translation software. Half of computer-generated Spanish prescription labels are either inaccurate or incomplete, according to a study published by the American Academy of Pediatrics. These lead to errors made by patients in following directions for use. Title of Study "Accuracy of Computer-Generated, Spanish-Language Medicine Labels"Authors: Iman Sharif, MD, MPH, Julia Tse, BAPublication: Official Journal of the American Academy of PediatricsDate: Published online April 5, 2010 http://pediatrics.aappublications.org/content/early/2010/04/05/peds.2009-2530.abstract

Common Errors in Labeling Methods: A survey of all pharmacies in the Bronx, New York, was performed. Selected pharmacies were visited to learn about the computer software being used to generate Spanish medicine labels. Outcomes included the proportion of pharmacies providing Spanish medicine labels, frequency of computerized translation, and description of Spanish medicine labels produced. Title of Study "Accuracy of Computer-Generated, Spanish-Language Medicine Labels"Authors: Iman Sharif, MD, MPH, Julia Tse, BAPublication: Official Journal of the American Academy of PediatricsDate: Published online April 5, 2010 http://pediatrics.aappublications.org/content/early/2010/04/05/peds.2009-2530.abstract Common Errors in Labeling Results: Pharmacies that provided Spanish labels mostly commonly (86%) used computer programs to do so; 11% used lay staff members, and 3% used a professional interpreter. We identified 14 different computer programs used to generate Spanish labels, with 70% of pharmacies using 1 of 3 major programs. (43%) included incomplete translations (a mixture of English and Spanish) and additional labels contained misspellings or grammar errors, which resulted in an overall error rate of 50%. Title of Study "Accuracy of Computer-Generated, Spanish-Language Medicine Labels"Authors: Iman Sharif, MD, MPH, Julia Tse, BAPublication: Official Journal of the American Academy of PediatricsDate: Published online April 5, 2010 http://pediatrics.aappublications.org/content/early/2010/04/05/peds.2009-2530.abstract Common Errors in Labeling Phrases that were not translated included dropperfuls, apply topically, for 7 days, for 30 days, apply to affected areas, with juice, take with food, and once a day. Deviations included errors such as by the little for the translation of the misspelled Spanish word poca (for boca, meaning mouth ), two kisses for the translation of the Spanish phrase dos veces (meaning two times ), and eleven times a day for the translation of the phrase once a day. Common Errors in Labeling Conclusions: Although pharmacies were likely to provide medicine labels translated into Spanish, the quality of the translations was inconsistent and potentially hazardous. Unless regulations and funding support the technological advances needed to ensure the safety of such labeling, we risk perpetuating health disparities for populations with limited English proficiency. poca = a little veces = times once = eleven boca = mouth besos = kisses Title of Study "Accuracy of Computer-Generated, Spanish-Language Medicine Labels"Authors: Iman Sharif, MD, MPH, Julia Tse, BAPublication: Official Journal of the American Academy of PediatricsDate: Published online April 5, 2010 http://pediatrics.aappublications.org/content/early/2010/04/05/peds. 2009-2530.abstract http://pediatrics.aappublications.org/content/early/2010/04/05/peds. 2009-2530.abstract

How to Solve the Problem Obviously, there is still a need to serve Hispanic patients with directions in their first language even though the risk of error is high with translation software. An knowledge of job-specific Spanish on the part of pharmacy professionals will help them to proof such translations for errors and to develop a better rapport with their patients. Learning how to state some of the most common directions for use in Spanish is a fantastic start. First, we'll do a brief pronunciation overview and then we'll learn components of directions for use in Spanish. It is important that from here until the end of the presentation that you repeat aloud the sounds, words and phrases after me for practice. Las Vocales - Vowels Do not draw out the vowels. Keep them short. There is only one way to pronounce each vowel in Spanish. None are silent. Each is always pronounced as follows: Letter: Sound: Example: a ah mañana (tomorrow) e ay mes (month) i ee libro (book) o oh dolor (pain) u oo computadora (computer) * y ee muy (very) The Pronunciation of Spanish Vowels Practice Activity How would you pronounce the following? pulmones medicina La Cantidad / Quantity First, you will need to tell the patient HOW MUCH of the medicine to take: one ounce una onza oo-nah own-sah two ounces, etc. dos onzas dohs own-sahs...and a half...y media ee may-dee-ah a fourth of... un cuarto de... oon k'warr-toe day garganta diabetes dificultad embarazada a third of... una tercera de... oo-nah tare-say-rah day a half of... la mitad de... la me-todd day one tablespoon una cucharada oo-nah koo-cha-rah-dah two tablespoons dos cucharadas dohs koo-chah-rah-dahs

one teaspoon una cucharita oo-nah koo-cha-ree-tah two teaspoons dos cucharitas dohs koo-cha-ree-tahs one drop una gota oo-nah go-tah two drops dos gotas dohs go-tahs one dropperful un gotero lleno oon go-tay-rah yay-no two droppers full dos goteros llenos dohs go-tay-rahs yay-nohs un aplicador oon ah-plee-kah-door one applicator full lleno yay-no two applicators full dos aplicadores llenos dohs ah-plee-kah-door-ace yay-nohs a liter un litro oon lee-troh a milliliter un mililitro oon me-lee-lee-troh a gram un gramo oon grah-ma a milligram un miligramo oon me-lee-grah-moe oon k'warr-toe day tah-blaytah ¼ tablet un cuarto de tableta oo-nah me-todd day tahblay-tah ½ tablet una mitad de tableta one tablet una tableta oo-nah tah-blay-tah two tablets dos tabletas dohs tah-blay-tahs one pill una píldora oo-nah peel-door-ah two pills dos píldoras dohs peel-door-ahs one capsule una cápsula oo-nah cop-sue-lah two capsules dos cápsulas dohs cop-sue-lahs La Frecuencia / Frequency Next, you will need to tell the patient WHEN to take the medicine: once daily una vez al día oo-nah base all dee-ah twice daily dos veces al día dohs bay-sace all dee-ah 3 times daily tres veces al día trace bay-sace all dee-ah # times a day # veces al día _#_ bay-sace all dee-ah every other day /every two days once weekly / once a week cada dos días una vez a la semana kah-dah dohs dee-ahs oo-nah base ah la say-ma-nah

twice weekly / twice a week dos veces a la semana # times a week # veces a la semana until gone hasta que no hay más dohs bay-sace ah la say-ma-nah _#_ bay-sace ah la say-ma-nah ah-stah kay no eye mahs every # hours cada _#_ horas kah-dah # oh-rahs every 4 hours every 6 hours every 4 to 6 hours cada cuatro horas kah-da k'wah-troh oh-rahs cada seis horas kah-da sace oh-rahs cada cuatro a seis horas kah-dah k wah-troh ah sace oh-rahs Cómo? How? as directed by your doctor as needed for pain when you have...(pain, etc.) only when you need it Next, you will need to tell the patient HOW to take the medicine: como dirigido por su doctor si la necesite para el dolor cuando tenga...(dolor de, etc.) sólo cuando lo necesite ko-mo dee-ree-he-doe pour sue doke-tore see la nay-say-see-tay pa-rah ale doe-lore k'wann-doe tain-gah (doe-lore day) so-lo k'wann-doe lo nay-say-see-tay in the morning/ afternoon/ evening before bedtime por la mañana/ tarde/ noche antes de acostarse pour la mahn-ya-nah / tar-day / no-chay ahn-tace day ah-ko-star-say right now ahora mismo ah-oar-ah meece-mo by mouth por boca pour bow-kah with meals con las comidas cone lahs ko-me-dahs with food con un alimento cone oon ah-lee-main-toe with food con comida cone ko-me-dah after meals before meals before breakfast after supper después de las comidas antes de las comidas antes del desayuno después de la cena dace-p'wace day lahs ko-me-dahs ahn-tace day lahs ko-me-dahs ahn-tace dale day-sah-you-no dace-p'wace day la say-nah

with lunch between meals on an empty stomach con el almuerzo cone ale all-m'ware-so entre las comidas en ayunas ain-tray lahs ko-me-dahs ain ah-you-nahs with water con agua cone ah-g'wah mixed with food mixed with liquids when you take / eat / drink mezclada con un alimento mezclada con líquidos cuando tome... mace-klah-dah cone oon ah-lee-main-toe mace-klah-dah cone lee-key-dohs k'wann-doe toe-may To Obtain the Following Free Resources go to www.handsonspanish.com/freece An enhanced player version of this presentation with audio. Video Series: The Seven Most Common Spanish Pronunciation Errors Made by English Speakers PDF download of the Pharmacy Spanish Behind the Counter Spanish Cheat Sheet of common Spanish pharmacy words, their English meanings and an easy pronunciation guide mp3 of the audio for the cheat sheet Preguntas - Questions Notes We will now begin the Q&A session. www.handsonspanish.com/freece