Language Barriers Limit Counseling Effectiveness with Older Patients

Language barriers among community pharmacists significantly limit their counseling abilities among older adult patients, highlighting the need for better language training among pharmacy employees, according to Exploratory Research in Clinical and Social Pharmacy.¹

“Effective communication between pharmacy staff and patients is essential in ensuring that patients receive accurate medication information, understand proper usage, and are aware of potential side effects or interactions,” wrote the authors of the study. “However, language barriers often limit patients' understanding of medication instructions and lead to poor health outcomes, especially in settings with linguistically diverse populations.”

In the fast-paced environment of a modern pharmacy, effective verbal communication is the cornerstone of patient safety, yet a critical care gap is emerging as populations age and diversify. A recent study conducted in Singapore reveals a troubling disparity in the self-efficacy of pharmacy staff when providing medication counseling to older adults in languages other than English.¹

Although staff reported high confidence in English-mediated interactions, their perceived capability dropped significantly when using Mandarin, Malay, or various Chinese dialects. Most alarmingly, the study found that across every language and dialect, pharmacy professionals felt the least confident when tasked with explaining potentially serious medication-related health risks.

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This lack of confidence is more than a personal hurdle for pharmacists. It is also a direct threat to medication adherence and health outcomes for a vulnerable demographic. Older adults often manage complex medication regimens and are more susceptible to medication-related harm if they misunderstand dosing instructions or side effects.¹

When a language barrier exists, the pharmacy essentially acts as the last line of defense for the patient, who may have already missed opportunities to ask questions during a brief physician visit. Research from the University of Kansas School of Pharmacy underscores that when pharmacy staff appear uncomfortable with a patient’s ethnic or linguistic background, the patient is less likely to engage thoroughly, potentially leading to incomplete counseling and hazardous misunderstandings.²

The challenge is a global one, transcending borders from Singapore to the United Kingdom and the US. In the UK, data indicates that nonproficient English speakers are more likely to report poor health, yet as many as 86% of community pharmacy professionals report having no access to formal translation services.^3,4

This lack of resources often forces pharmacists to rely on risky, nonvalidated methods such as Google Translate, which has been shown to have limited accuracy for medical terminology, or a patient’s family members, which introduces potential bias and privacy concerns.^3,4 In the US, even when computer-based resources like Spanish-language labels and leaflets are available, they are infrequently used, despite a clear correlation between resource accessibility and increased pharmacist self-efficacy, according to a separate study in Exploratory Research in Clinical and Social Pharmacy.⁵

To address these systemic failings, some organizations are moving toward more tailored, trust-based models. Fallon Health, for instance, has focused on building a network of community pharmacies where members can consult with staff in their native language, prioritizing in-person support over telephonic services to overcome cultural biases and logistical hurdles, according to the Building Trust initiative.⁶

Such initiatives demonstrate that providing care in a patient's native language fosters a safe environment and builds the confidence necessary for informed decision-making. Furthermore, incorporating visual aids and pictograms directly onto medication labels can serve as a universal language that bridges literacy and linguistic gaps.^1,6

The responsibility for closing this gap lies in both institutional support and professional development. Experts argue that pharmacy schools must play a pivotal role by integrating multilingual communication and cultural intelligence into their core curricula, ensuring that the next generation of pharmacists is equipped with medical terminology in multiple languages before entering clinical practice.^1,2,4

By embracing multilingualism, not merely as a convenience but as a fundamental requirement for health equity, the pharmacy profession can ensure that every patient—regardless of the language they speak—is genuinely heard, understood, and safely cared for.⁴

“These findings suggest the need for targeted support to strengthen language capabilities among pharmacy staff,” concluded the authors of the current study.¹ “Henceforth, health care institutions can look towards supporting pharmacy staff in language and dialect acquisition while also implementing visual aids on medication labels to enhance effective communication between staff and older adults of various literacy and language capabilities.”

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REFERENCES

1. Suppiah SD, Goh M, Yang X, et al. Language-related self-efficacy of pharmacy staff in providing medication counselling to older adults in a linguistically diverse setting. Explor Res Clin Soc Pharm. 2026;23:100785. https://doi.org/10.1016/j.rcsop.2026.100785

2. Lynch BM. Pharmacy care seen differently by diverse populations, including patients with disabilities. University of Kansas School of Pharmacy. May 13, 2025. Accessed April 21, 2026. https://pharmacy.ku.edu/news/article/study-reveals-pharmacy-care-perceived-differently-by-diverse-populations-including-patients-with-disabilities

3. Patel J. Pharmacy is failing patients with language barriers — we must do better. The Pharmaceutical Journal. July 17, 2023. Accessed April 21, 2026. https://pharmaceutical-journal.com/article/opinion/pharmacy-is-failing-patients-with-language-barriers-we-must-do-better

4. Reyes Quiles G. Multilingual pharmacists create bridge of communication, access for patients. Pharmacy Times. January 15, 2024. Accessed April 21, 2026. https://www.pharmacytimes.com/view/multilingual-pharmacists-create-bridge-of-communication-access-for-patients

5. Devraj R, Young HN. Pharmacy language assistance resources and their association with pharmacists’ self-efficacy in communicating with Spanish-speaking patients. Res Social Adm Pharm. 2016;13(1):123-132. https://doi.org/10.1016/j.sapharm.2016.02.005

6. Access to pharmacy support for members with language barriers. Building Trust. 2020. Accessed April 21, 2026. https://buildingtrust.org/practice/access-to-pharmacy-support-for-members-with-language-barriers/