Interventions to optimize medication management in patients with language and health literacy barriers: A scoping review.

Abstract

Background: Language barriers can pose significant challenges to effective communication about medications. When language barriers are present, patients may struggle to understand medication instructions and potential side effects, which can lead to medication errors, poor health outcomes, and increased healthcare costs.

Objective: We aimed to identify patient-facing interventions beyond the use of medical interpreters aimed at helping patients with language barriers manage their medications.

Methods: We searched PubMed using the PICO (population, intervention, control, outcome) framework from the beginning of the database to January 2023. We included all study designs with an intervention. Two reviewers independently performed citation screening. We synthesized the data using a narrative approach and developed a conceptual model which can be used to design interventions to improve medication management among patients with language barriers, low health literacy, and/or low literacy.

Results: 19 studies met our eligibility criteria. Interventions included utilization of community health workers to improve medication adherence, the use of pictograms and simplified medication instructions, and mobile apps with medication information. Interventions were delivered by pharmacists, health coaches, and community health workers. Studies examined a variety of outcomes, from medication adherence, patient satisfaction, knowledge about medications, and clinical outcomes, such as hemoglobin A1c and blood pressure measures.

Conclusion: The studies reviewed reported mixed effectiveness for improving medication management. Most studies were exploratory in nature; some interventions demonstrated effectiveness in a clinical setting. Generally, the reviewed studies suggest a need to expand and test interventions for complex medical instructions and develop studies with longer follow-up periods.