If you are not Caucasian, what are you? Hispanic or Latino? Black or African American? Japanese or Asian? Are you a person of color? Does it matter?
As a company that deals with communication across countries and cultures, this question comes up often and using “correct” terminology can be quite a struggle.
Recently we translated a brochure for a company into several languages, one of which was Japanese. The photo on the front contained a handsome Asian man. Upon final review our Japanese translator rejected the brochure based on the cover photo and suggested we instead picture a Caucasian American male. She said people from Japan do not consider themselves to be Asian.
I find this interesting.
How do Americans view themselves? If you are American but born of Costa Rican descent, how do you identify yourself? Do you distinguish yourself as Costa Rican or American? Do you consider yourself to be Latino? Which self-identity is stronger: that of your heritage or of the country you live in?
Clearly this is a personal preference which will keep communications professionals on their toes for a very long time. In one breath, a person can be Black, African-American, a person of color and American. That is the beauty of living in a Global Age. You can be whatever you want to be.
Wednesday, December 23, 2009
Friday, December 11, 2009
Adonde vas tu? Or Adonde tu vas?
Language is an organic, ever-changing phenomenon reflected by its speakers. Documenting the linguistic diversity found in 400 million Spanish speakers is no easy feat, but yesterday, the Spanish Royal Academy presented its 4,000 page best shot.
Titled, Nueva Gramática de la Lengua Española, it attempts to account for variances in Spanish throughout the world and is billed as a "map" of the Spanish language. The surprising revelation in the Academy's work is acknowledging the influence Latin America has had on the language. It looks at how vocabulary, pronunciation and grammar change between countries and within social classes. While the Academy makes recommendations for “proper” Spanish, it recognizes localization and the influence of new words, positioning its purpose as one to “observe and document.”
Thus continues the struggle communicators and marketers have in creating a single set of Spanish documents. Spanish is highly localized. The less technical a communication is, the more localized it becomes. In fact, the Academy acknowledges there are more than 20 acceptable ways to say "Ball Point Pen."
In market research, patient education and patient recruitment, the possibility of alienating the reader is not resolved by the issuance of the Academy's work. While the work is interesting and important, the daily work of the Spanish translator goes on. Who is my audience? Where do they live and what is their social class? How can I reach them best?
Titled, Nueva Gramática de la Lengua Española, it attempts to account for variances in Spanish throughout the world and is billed as a "map" of the Spanish language. The surprising revelation in the Academy's work is acknowledging the influence Latin America has had on the language. It looks at how vocabulary, pronunciation and grammar change between countries and within social classes. While the Academy makes recommendations for “proper” Spanish, it recognizes localization and the influence of new words, positioning its purpose as one to “observe and document.”
Thus continues the struggle communicators and marketers have in creating a single set of Spanish documents. Spanish is highly localized. The less technical a communication is, the more localized it becomes. In fact, the Academy acknowledges there are more than 20 acceptable ways to say "Ball Point Pen."
In market research, patient education and patient recruitment, the possibility of alienating the reader is not resolved by the issuance of the Academy's work. While the work is interesting and important, the daily work of the Spanish translator goes on. Who is my audience? Where do they live and what is their social class? How can I reach them best?
Wednesday, November 18, 2009
Should Crowdsourcing Be In Your Mix?
Crowdsourcing: Jeff Howe coined the term and wrote the book; many companies are buying into the idea. Wikipedia defines it as "the act of taking a task traditionally performed by an employee or contractor, and outsourcing it to an undefined, generally large group of people, in the form of an open call.”
To use the collective intelligence of many to do the work of a specialized few is good in theory. When it saves companies money, all the better, right? If you have a large, diverse group of qualified people, the knowledge of the crowd is a useful resource.
Is crowdsourcing the answer to the growing need for translations?
Crowdsourcing translation work for free has gotten a lot of press lately. No longer are non-profit companies requesting help on the cheap, companies are using free labor for profit. Internet sites like Facebook, Google, and LinkedIn all crowdsource translations and the industry seems to embrace it.
According to Howe, “[i]f there is one industry where crowdsourcing can turn things upside down, it is the translation industry.” Based solely on supply and demand, Howe claims the few hundred thousand translators existing worldwide are not enough to meet the growing need.
What about quality? In general, good professional translators will not work for free. If they do, it is for passion or prestige. Translating is laborious and intensive work. A good translation is not something the majority of native speakers of any language can produce. It is kind of like saying all English speakers are great English writers.
Ultimately, there is a place for crowdsourcing in the mix of human and machine translation but it is not the solution for everyone. It is not a good option for companies concerned about their brand, or in the highly-technical medical or legal fields where precision is unyieldingly required and confidentiality would preclude dumping out content to the masses.
Companies need to consider which solution will yield the best and most cost effective results and plan accordingly. Where quality is less important than cost, and where deadlines are unimportant, crowdsourcing translation projects is effective, but the reality is, you get what you pay for.
To use the collective intelligence of many to do the work of a specialized few is good in theory. When it saves companies money, all the better, right? If you have a large, diverse group of qualified people, the knowledge of the crowd is a useful resource.
Is crowdsourcing the answer to the growing need for translations?
Crowdsourcing translation work for free has gotten a lot of press lately. No longer are non-profit companies requesting help on the cheap, companies are using free labor for profit. Internet sites like Facebook, Google, and LinkedIn all crowdsource translations and the industry seems to embrace it.
According to Howe, “[i]f there is one industry where crowdsourcing can turn things upside down, it is the translation industry.” Based solely on supply and demand, Howe claims the few hundred thousand translators existing worldwide are not enough to meet the growing need.
What about quality? In general, good professional translators will not work for free. If they do, it is for passion or prestige. Translating is laborious and intensive work. A good translation is not something the majority of native speakers of any language can produce. It is kind of like saying all English speakers are great English writers.
Ultimately, there is a place for crowdsourcing in the mix of human and machine translation but it is not the solution for everyone. It is not a good option for companies concerned about their brand, or in the highly-technical medical or legal fields where precision is unyieldingly required and confidentiality would preclude dumping out content to the masses.
Companies need to consider which solution will yield the best and most cost effective results and plan accordingly. Where quality is less important than cost, and where deadlines are unimportant, crowdsourcing translation projects is effective, but the reality is, you get what you pay for.
Thursday, November 12, 2009
DUR 2T YR RX?
Reaching a global patient means more than just speaking their native language. You have to know HOW to reach them too.
What is the one thing you rarely see a teenager without?
That’s right: their cell phone.
It rings and bings constantly as text messages, Tweets and Facebook posts stream in.
If they happen to be one of the 186,300 people under the age of 20 who have diabetes, why not put that attachment to good use?
Historically, healthcare professionals have struggled to gain teen compliance, with little success; however, a recent study published in the Journal of Pediatrics suggests texting may be the way to make it happen.
Researchers used a program to send text messages to young liver transplant patients reminding them to take their medications. The results were “with text messaging, patients were more likely to take their medications than they had been before.”
Let’s apply this lesson. Whether you communicate in English, Spanish or Mandarin, the message is only effective if it reaches the intended target.
DUR 2T YR RX?
(Did you remember to take your medication?)
What is the one thing you rarely see a teenager without?
That’s right: their cell phone.
It rings and bings constantly as text messages, Tweets and Facebook posts stream in.
If they happen to be one of the 186,300 people under the age of 20 who have diabetes, why not put that attachment to good use?
Historically, healthcare professionals have struggled to gain teen compliance, with little success; however, a recent study published in the Journal of Pediatrics suggests texting may be the way to make it happen.
Researchers used a program to send text messages to young liver transplant patients reminding them to take their medications. The results were “with text messaging, patients were more likely to take their medications than they had been before.”
Let’s apply this lesson. Whether you communicate in English, Spanish or Mandarin, the message is only effective if it reaches the intended target.
DUR 2T YR RX?
(Did you remember to take your medication?)
Monday, October 26, 2009
Help Recruit the Rarest Patient
Half of all clinical trial delays are a result of patient recruitment problems. Imagine the struggle faced by researchers of rare diseases. In addition to the normal recruitment problems, as well as the standard 20-30% post enrollment dropout rate, they are working with very limited patient populations.
To get viable results for rare disease studies you need adequate participation. The problem is people receiving Supplemental Social Security income are not allowed by US law to accept compensation for research. Doing so makes them ineligible to receive government medical benefits and prevents them from participating in clinical studies. Take that limited pool of participants and make it smaller. Now find a cure. Good luck.
As of the end of September, over 100 patient, academic and industry organizations have joined to support legislation that enables individuals with rare diseases to participate in clinical trials without losing their eligibility for government assisted healthcare benefits. Some of these include the Cystic Fibrosis Foundation, Johns Hopkins Hospital, the National Health Council, PhRMA and the Yale University Medical College.
According to Robert Beall, PhD., President and CEO of the Cystic Fibrosis Foundation, “Clinical trials are critical for developing effective therapies for cystic fibrosis and dozens of other rare diseases. Quick passage of this bill by Congress will support life-saving research for many people in need.” (Medical News Today 9/29/09)
The bill was introduced into the Senate September 16th and is called “The Improving Access to Clinical Trials Act.”
“This bill allows patients with a rare disease to disregard up to $2,000 of compensation received for participation in a clinical trial in their SSI and Medicaid income calculations,” said Senator Inhofe. “Though it will have a negligible impact on the federal budget, it will make a dramatic difference in the lives of those who will gain access to potentially life-saving treatments by enrolling in clinical trials as well as all those in the future whose lives will be improved by the medical advances that arise from this research.”
Over 30 million Americans are afflicted with one of the roughly 700 existing rare diseases and it is estimated two new pathologies are described every week in medical publications.
To track the current status of this bill, please click here: http://www.govtrack.us/congress/bill.xpd?bill=h111-2866
Please feel free to let your elected House and Senate representatives know you support this bill. Their contact information can be found here: http://www.usa.gov/Contact/Elected.shtml
You can even Tweet your support!
To get viable results for rare disease studies you need adequate participation. The problem is people receiving Supplemental Social Security income are not allowed by US law to accept compensation for research. Doing so makes them ineligible to receive government medical benefits and prevents them from participating in clinical studies. Take that limited pool of participants and make it smaller. Now find a cure. Good luck.
As of the end of September, over 100 patient, academic and industry organizations have joined to support legislation that enables individuals with rare diseases to participate in clinical trials without losing their eligibility for government assisted healthcare benefits. Some of these include the Cystic Fibrosis Foundation, Johns Hopkins Hospital, the National Health Council, PhRMA and the Yale University Medical College.
According to Robert Beall, PhD., President and CEO of the Cystic Fibrosis Foundation, “Clinical trials are critical for developing effective therapies for cystic fibrosis and dozens of other rare diseases. Quick passage of this bill by Congress will support life-saving research for many people in need.” (Medical News Today 9/29/09)
The bill was introduced into the Senate September 16th and is called “The Improving Access to Clinical Trials Act.”
“This bill allows patients with a rare disease to disregard up to $2,000 of compensation received for participation in a clinical trial in their SSI and Medicaid income calculations,” said Senator Inhofe. “Though it will have a negligible impact on the federal budget, it will make a dramatic difference in the lives of those who will gain access to potentially life-saving treatments by enrolling in clinical trials as well as all those in the future whose lives will be improved by the medical advances that arise from this research.”
Over 30 million Americans are afflicted with one of the roughly 700 existing rare diseases and it is estimated two new pathologies are described every week in medical publications.
To track the current status of this bill, please click here: http://www.govtrack.us/congress/bill.xpd?bill=h111-2866
Please feel free to let your elected House and Senate representatives know you support this bill. Their contact information can be found here: http://www.usa.gov/Contact/Elected.shtml
You can even Tweet your support!
Thursday, October 15, 2009
Is the "Pink" Message Getting To You?
Pink is hot right now. In case you have missed the signs: from pink gloves and sneakers worn by NFL players to the barrage of ads on the TV and radio, October is Breast Cancer Awareness Month.
According to the American Cancer Society, 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease. Studies show that women who undergo reconstructive surgery after a mastectomy experience better quality of life. Reconstruction boosts self-esteem, body image and sexuality. Not all women choose reconstruction but all women should at least be presented with the option.
This is not always the case. A recent study, published in the Journal of Clinical Oncology, compared breast reconstruction among white women, African American women, Latina women who were highly acculturated (integrated into American society) and Latina women who were less acculturated. Of the 806 women studied, 41% of white women, 41% of highly acculturated Latinas and 34% of African American women underwent reconstruction; whereas, only 14% of less acculturated Latinas did.
Study researchers, from the University of Michigan Comprehensive Cancer Center, found the lower rate was not due to lack of interest. More than half of the less acculturated Latinas responded they would have liked more information about reconstructive surgery. They also claim this group was less likely to report their surgeon explained reconstruction to them or referred them to a plastic surgeon.
The study recommends better efforts be made to present breast reconstruction options to all patients, including those who do not speak English. They plan to do further research to understand how language and cultural issues affect a women’s choice to undergo reconstructive surgery post-mastectomy.
In addition to understanding their reconstructive options, targeted breast cancer awareness messages need to be directed at minority ethnic groups explaining symptoms, availability of screenings and insurance coverage. Women diagnosed with breast cancer in its earliest stage have a 9 out of 10 survival rate beyond five years. For cancer in its latest stage that has metastasized to other areas of the body, this rate drops to 1 out of 10. As you can see, early detection is key to survival.
This month is all about breast cancer awareness. For early detection and better survival, let’s make sure the “pink” message gets to everyone!
For more information about breast cancer in English and Spanish, including screening, prevention and treatment options, please visit the National Cancer Institute website:
http://www.cancer.gov/cancertopics/types/breast
According to the American Cancer Society, 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease. Studies show that women who undergo reconstructive surgery after a mastectomy experience better quality of life. Reconstruction boosts self-esteem, body image and sexuality. Not all women choose reconstruction but all women should at least be presented with the option.
This is not always the case. A recent study, published in the Journal of Clinical Oncology, compared breast reconstruction among white women, African American women, Latina women who were highly acculturated (integrated into American society) and Latina women who were less acculturated. Of the 806 women studied, 41% of white women, 41% of highly acculturated Latinas and 34% of African American women underwent reconstruction; whereas, only 14% of less acculturated Latinas did.
Study researchers, from the University of Michigan Comprehensive Cancer Center, found the lower rate was not due to lack of interest. More than half of the less acculturated Latinas responded they would have liked more information about reconstructive surgery. They also claim this group was less likely to report their surgeon explained reconstruction to them or referred them to a plastic surgeon.
The study recommends better efforts be made to present breast reconstruction options to all patients, including those who do not speak English. They plan to do further research to understand how language and cultural issues affect a women’s choice to undergo reconstructive surgery post-mastectomy.
In addition to understanding their reconstructive options, targeted breast cancer awareness messages need to be directed at minority ethnic groups explaining symptoms, availability of screenings and insurance coverage. Women diagnosed with breast cancer in its earliest stage have a 9 out of 10 survival rate beyond five years. For cancer in its latest stage that has metastasized to other areas of the body, this rate drops to 1 out of 10. As you can see, early detection is key to survival.
This month is all about breast cancer awareness. For early detection and better survival, let’s make sure the “pink” message gets to everyone!
For more information about breast cancer in English and Spanish, including screening, prevention and treatment options, please visit the National Cancer Institute website:
http://www.cancer.gov/cancertopics/types/breast
Monday, October 12, 2009
Ayudame...
In your day to day conversations, when the subject of human trafficking arises, images of young girls on the streets of Japan or India probably cross your mind. What you may not realize is that human trafficking is alive and well right here in the United States. Cases of human trafficking have been reported in all 50 states, Washington D.C. and some US territories.
According to the US Department of State, an estimated 14,500 to 17,500 foreign nationals are trafficked into the US annually for the purposes of commercial sex and/or labor exploitation or domestic servitude. Traffickers use force, fraud and coercion to compel women, men and children to engage in these activities.
Most sources agree, the covert nature of the crime, relative invisibility of its victims and the extreme amount of under reporting of the crime, mean these numbers are probably low estimates. Our melting pot identity sets up the US to be a trafficking magnet with people commonly trafficked from East Asia, Central & South America and Eastern Europe.
The greatest challenge lies in reaching and identifying victims. More needs to be done to reach victims in their native language and increased cross cultural and linguistic training activities need to be provided for social workers, health care professionals and law enforcement workers. It’s great that there is a 24-hour hotline you can call for assistance, but if you are petrified and only speak Korean, will the English speaking person on the other end be able to help you?
Victims need to understand information about their rights and translation services need to be made available. In the time period between, October of 2000 and fiscal year 2007, the Department of Health and Human Services (HHS) certified 1,379 foreign national victims of human trafficking. Despite the fact that over 10,000 people are trafficked into the US every year, only hundreds are assisted. Clearly more effort needs to be made to reach the people that need our help the most.
If you suspect a trafficking crime or need help, please call the national 24 hour toll-free Human Trafficking Resource Center at: 1-888-373-7888.
According to the US Department of State, an estimated 14,500 to 17,500 foreign nationals are trafficked into the US annually for the purposes of commercial sex and/or labor exploitation or domestic servitude. Traffickers use force, fraud and coercion to compel women, men and children to engage in these activities.
Most sources agree, the covert nature of the crime, relative invisibility of its victims and the extreme amount of under reporting of the crime, mean these numbers are probably low estimates. Our melting pot identity sets up the US to be a trafficking magnet with people commonly trafficked from East Asia, Central & South America and Eastern Europe.
The greatest challenge lies in reaching and identifying victims. More needs to be done to reach victims in their native language and increased cross cultural and linguistic training activities need to be provided for social workers, health care professionals and law enforcement workers. It’s great that there is a 24-hour hotline you can call for assistance, but if you are petrified and only speak Korean, will the English speaking person on the other end be able to help you?
Victims need to understand information about their rights and translation services need to be made available. In the time period between, October of 2000 and fiscal year 2007, the Department of Health and Human Services (HHS) certified 1,379 foreign national victims of human trafficking. Despite the fact that over 10,000 people are trafficked into the US every year, only hundreds are assisted. Clearly more effort needs to be made to reach the people that need our help the most.
If you suspect a trafficking crime or need help, please call the national 24 hour toll-free Human Trafficking Resource Center at: 1-888-373-7888.
Friday, October 2, 2009
I Am How I Feel
Our previous blog recounted a study that showed educational cues incited better vaccination habits in women versus emotional consumer ads or government mandates. In this study, education served to motivate better than emotion. Does that mean we should discount the effect emotion has on our identity and thus decisions we make about our health?
It’s true. Culture has a big impact on our perception of the world. However, can feeling emotionally good or bad make you act outside your cultural norms? Scientists decided to put this theory to the test and discovered that indeed, emotion has an effect on your cultural identity.
A journal article entitled, “Who I Am Depends on How I Feel: The Role of Affect in the Expression of Culture” outlines these results in Psychological Science. Scientists recruited volunteers from opposing cultural identities: Westerners, noted to value individuality and independence and East Asians who culturally value harmony and community. Then the unconscious tinkering began. To lift their mood they played upbeat music (Mozart), had them hold pens in their teeth (it force a smile). To bring them down they played Rachmaninov and had them hold the pen in their lips (forcing a frown).
Volunteers would then take a test to check for individualistic or group values: for example, given a choice of five pens, one red, the rest blue, which one would they pick? According to their stereotypical cultural values, the Western recruits should go for the red pen and the East Asian recruits should choose from the blue.
Their results were consistent in all the tests. Feeling good results in volunteers acting more exploratory and out of character whereas feeling badly reinforced cultural stereotypes and thought patterns. East Asians acted more independently and Westerners became more communal.
The researchers suggest “these experiments demonstrate a robust moderation of the expression of culture by affective state.” While past studies have shown culture can predict responses based on affect, this study shows it also works in reverse: affect can determine one’s expression of culture.
They also suggest, “Who one is-one’s behaviors, cognitions and self-construals-at any given point in time depends on the fundamental interplay between affect and culture.
Good to know.
By Sherry Dineen
It’s true. Culture has a big impact on our perception of the world. However, can feeling emotionally good or bad make you act outside your cultural norms? Scientists decided to put this theory to the test and discovered that indeed, emotion has an effect on your cultural identity.
A journal article entitled, “Who I Am Depends on How I Feel: The Role of Affect in the Expression of Culture” outlines these results in Psychological Science. Scientists recruited volunteers from opposing cultural identities: Westerners, noted to value individuality and independence and East Asians who culturally value harmony and community. Then the unconscious tinkering began. To lift their mood they played upbeat music (Mozart), had them hold pens in their teeth (it force a smile). To bring them down they played Rachmaninov and had them hold the pen in their lips (forcing a frown).
Volunteers would then take a test to check for individualistic or group values: for example, given a choice of five pens, one red, the rest blue, which one would they pick? According to their stereotypical cultural values, the Western recruits should go for the red pen and the East Asian recruits should choose from the blue.
Their results were consistent in all the tests. Feeling good results in volunteers acting more exploratory and out of character whereas feeling badly reinforced cultural stereotypes and thought patterns. East Asians acted more independently and Westerners became more communal.
The researchers suggest “these experiments demonstrate a robust moderation of the expression of culture by affective state.” While past studies have shown culture can predict responses based on affect, this study shows it also works in reverse: affect can determine one’s expression of culture.
They also suggest, “Who one is-one’s behaviors, cognitions and self-construals-at any given point in time depends on the fundamental interplay between affect and culture.
Good to know.
By Sherry Dineen
Thursday, September 17, 2009
Use Education, Not Emotion: Get People to Buy What You Are Selling
Our fall newsletter (something to look forward to!) will focus on marketing and research within global audiences. If you find pharmaceutical marketing tactics of interest, you should consider contacting Michelle Steward, assistant professor of marketing at Wake Forest University.
Her study, entitled, "The Influence of Different Types of Cues-to-Action on Vaccination Behavior: An Exploratory Study," will be featured in the Spring Edition of Journal of Marketing Theory and Practice.
The study considered the effects of educational surveys, consumer advertisements and governmental mandates on the HPV vaccination habits of women ages 18 through 30. It concluded they were more likely to consider being vaccinated after participating in the survey versus viewing consumer ads or receiving government mandates.
"The educational cues in the survey are the least coercive and appear to prompt more thinking about the risks of not being vaccinated than laws, which may produce a negative backlash or advertisements, of which consumers might be skeptical," said Steward.
Merck should take her survey to heart considering its sales of Gardasil for the second quarter of 2009 were $268 million, a decline of 28 percent from the same quarter last year. It is estimated 3 out of 4 women remain unvaccinated despite the millions of dollars Merck has spent on advertising and lobbying for mandated vaccinations.
Combine this theory with the current Health 2.0 trend where e-patients are educating themselves about their health online and targeted internet marketing campaigns should reap the reward of increased vaccination rates.
By Sherry Dineen
Source: “HPV Vaccine Study Show Why Few Women Getting Shots” by Medical News Today (www.medicalnewstoday.com)
Her study, entitled, "The Influence of Different Types of Cues-to-Action on Vaccination Behavior: An Exploratory Study," will be featured in the Spring Edition of Journal of Marketing Theory and Practice.
The study considered the effects of educational surveys, consumer advertisements and governmental mandates on the HPV vaccination habits of women ages 18 through 30. It concluded they were more likely to consider being vaccinated after participating in the survey versus viewing consumer ads or receiving government mandates.
"The educational cues in the survey are the least coercive and appear to prompt more thinking about the risks of not being vaccinated than laws, which may produce a negative backlash or advertisements, of which consumers might be skeptical," said Steward.
Merck should take her survey to heart considering its sales of Gardasil for the second quarter of 2009 were $268 million, a decline of 28 percent from the same quarter last year. It is estimated 3 out of 4 women remain unvaccinated despite the millions of dollars Merck has spent on advertising and lobbying for mandated vaccinations.
Combine this theory with the current Health 2.0 trend where e-patients are educating themselves about their health online and targeted internet marketing campaigns should reap the reward of increased vaccination rates.
By Sherry Dineen
Source: “HPV Vaccine Study Show Why Few Women Getting Shots” by Medical News Today (www.medicalnewstoday.com)
Tuesday, September 1, 2009
Turning Social Responsibility into Commercial Opportunity
For the first time in over fifty years, the U.S. pharmaceutical market is not forecasted to see better results than last year. As a result, disappointed drug manufacturers are making major changes in how they view their role in the world – from pharmaceutical companies to healthcare companies.
With this shift in perspective comes a broader sense of responsibility to patients in developing countries. In the past, most manufacturers’ involvement limited their involvement to simply making their products available to people in poorer nations. A change of heart, though, is moving companies toward partnerships and collaboration with governments, NGOs and other private sector organizations to develop long-term sustainable solutions for improved healthcare access and overall wellbeing in underserved patient populations.
In order to offset the loss of profit from the decline in the US market, however, pharmaceutical companies must realize increases in these challenging new foreign markets. But developing countries with poor populations have dynamics that can further complicate marketing and sales strategies beyond standard demographics and ROI. Following are some key issues that should be considered:
Literacy
Poorer countries tend to have lower literacy rates that can impede a patient's understanding of their condition and potential treatment options. It may also mask unethical behavior by providers or pharmacists. Low literacy patients require greater efforts of advocacy and additional support systems.
Language & Cultural Barriers
In many cultures, and more often in developing nations, physicians play a principle role in managing healthcare decisions and treatment choice. Questioning your doctor, or acting as a partner in your own care, is very often unheard of for patients in some cultures. Without culturally-appropriate translation of prescription and disease information, patients will be increasingly dependent on the information provided to them by their physician.
Cost
Drug makers have long been aware that in many countries, cost has a direct impact on a patient’s choice of treatment. Costs must be kept low to ensure compliance with physician treatment prescriptions. Due to the large number of new potential patients in developing countries, manufacturers may see the potential volume increase as an offset to the creation of special pricing structures that benefit the poor.
With this shift in perspective comes a broader sense of responsibility to patients in developing countries. In the past, most manufacturers’ involvement limited their involvement to simply making their products available to people in poorer nations. A change of heart, though, is moving companies toward partnerships and collaboration with governments, NGOs and other private sector organizations to develop long-term sustainable solutions for improved healthcare access and overall wellbeing in underserved patient populations.
In order to offset the loss of profit from the decline in the US market, however, pharmaceutical companies must realize increases in these challenging new foreign markets. But developing countries with poor populations have dynamics that can further complicate marketing and sales strategies beyond standard demographics and ROI. Following are some key issues that should be considered:
Literacy
Poorer countries tend to have lower literacy rates that can impede a patient's understanding of their condition and potential treatment options. It may also mask unethical behavior by providers or pharmacists. Low literacy patients require greater efforts of advocacy and additional support systems.
Language & Cultural Barriers
In many cultures, and more often in developing nations, physicians play a principle role in managing healthcare decisions and treatment choice. Questioning your doctor, or acting as a partner in your own care, is very often unheard of for patients in some cultures. Without culturally-appropriate translation of prescription and disease information, patients will be increasingly dependent on the information provided to them by their physician.
Cost
Drug makers have long been aware that in many countries, cost has a direct impact on a patient’s choice of treatment. Costs must be kept low to ensure compliance with physician treatment prescriptions. Due to the large number of new potential patients in developing countries, manufacturers may see the potential volume increase as an offset to the creation of special pricing structures that benefit the poor.
Wednesday, August 19, 2009
Can Immigration Give You Cancer?
A recent study conducted at the University of Miami Miller School of Medicine found that first-generation Hispanic immigrants living in Florida are 40% more likely to develop cancer than people who did not emigrate from their native countries. While researchers admit that further research is needed to determine the cause of this group’s higher cancer rate, culture has an obvious impact.
The increase in cancers among first-generation immigrants living in Florida may be due to the development of unhealthy habits. In addition, more widespread diagnostic measures in the U.S. that lead to greater detection could play a part. - Dr. Paulo Pirheiro, Lead Researcher
Certainly, better access equals better health care; however, the influence of a new culture should not be discounted. Different eating habits, changes in leisure and fitness activities, and other lifestyle modifications are common immigrant experiences and can all have an impact on a person’s health and wellbeing.
But what about stress? Immigration to a new country and culture can be an extremely stressful event. How this stress impacts the health of the 30,000 study participants is a perspective that warrants further study. Established research confirms that long-term, chronic psychological stress has a negative impact on a person's overall health, yet there are conflicting results concerning it’s impact on cancer development.
Visit the National Cancer Institute for more information about the link between stress and cancer: http://www.cancer.gov/cancertopics/factsheet/Risk/stress.
The increase in cancers among first-generation immigrants living in Florida may be due to the development of unhealthy habits. In addition, more widespread diagnostic measures in the U.S. that lead to greater detection could play a part. - Dr. Paulo Pirheiro, Lead Researcher
Certainly, better access equals better health care; however, the influence of a new culture should not be discounted. Different eating habits, changes in leisure and fitness activities, and other lifestyle modifications are common immigrant experiences and can all have an impact on a person’s health and wellbeing.
But what about stress? Immigration to a new country and culture can be an extremely stressful event. How this stress impacts the health of the 30,000 study participants is a perspective that warrants further study. Established research confirms that long-term, chronic psychological stress has a negative impact on a person's overall health, yet there are conflicting results concerning it’s impact on cancer development.
Visit the National Cancer Institute for more information about the link between stress and cancer: http://www.cancer.gov/cancertopics/factsheet/Risk/stress.
Wednesday, July 15, 2009
Medical Insurance is Not Enough
Our current quarterly newsletter, CONNECT, focuses on language barriers in healthcare. (Not on our mailing list? Send an email to audrey.miller@atkinsinternational.com and include your name and email or mailing address.)
Our blog this week will continue with this theme.
A study led by Z. Jennifer Huang at the Department of International Health at Georgetown University supports the conclusion that simply having and affording medical insurance does not guarantee healthcare usage in this country. Language in fact can be a barrier to being healthy.
Ms. Huang studied 76 families from 3 different socioeconomic groups in the metropolitan D.C. area (42% of this area’s immigrant families are Asian.) To qualify for the study, families had to have both parents born in China and speaking Mandarin as their primary language.
From suburban areas there were 20 families in the low-income bracket, 45 in the middle to high income bracket and 11 urban families in the low income bracket from D.C.’s Chinatown area. Most families had access to either private or public health insurance coverage.
Families were asked if in the past year there was a time their child was sick and they chose not to seek health care. Anyone responding with a “yes” received a more detailed inquiry as to why.
According to Ms. Huang, the researchers were “surprised to find out the delayed care is more common in this population, especially the middle income group.” Since many in this group were insured, the researchers looked for issues beyond insurance coverage that affected healthcare utilization.
Ms. Huang found most parents did not get care because they could not find a Chinese speaking doctor or were unable to find an interpreter.
“Not many recent immigrant families know they can request translation service at clinics with federal funding.” Huang said.
More detailed reporting of this study can be found in the May 2009 issue of the Journal of Healthcare for the Poor and Underserved.
http://www.press.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/
by Sherry Dineen
Our blog this week will continue with this theme.
A study led by Z. Jennifer Huang at the Department of International Health at Georgetown University supports the conclusion that simply having and affording medical insurance does not guarantee healthcare usage in this country. Language in fact can be a barrier to being healthy.
Ms. Huang studied 76 families from 3 different socioeconomic groups in the metropolitan D.C. area (42% of this area’s immigrant families are Asian.) To qualify for the study, families had to have both parents born in China and speaking Mandarin as their primary language.
From suburban areas there were 20 families in the low-income bracket, 45 in the middle to high income bracket and 11 urban families in the low income bracket from D.C.’s Chinatown area. Most families had access to either private or public health insurance coverage.
Families were asked if in the past year there was a time their child was sick and they chose not to seek health care. Anyone responding with a “yes” received a more detailed inquiry as to why.
According to Ms. Huang, the researchers were “surprised to find out the delayed care is more common in this population, especially the middle income group.” Since many in this group were insured, the researchers looked for issues beyond insurance coverage that affected healthcare utilization.
Ms. Huang found most parents did not get care because they could not find a Chinese speaking doctor or were unable to find an interpreter.
“Not many recent immigrant families know they can request translation service at clinics with federal funding.” Huang said.
More detailed reporting of this study can be found in the May 2009 issue of the Journal of Healthcare for the Poor and Underserved.
http://www.press.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/
by Sherry Dineen
Monday, July 13, 2009
Understanding is Key to Staying Out of the Hospital - Part II
Monday’s Blog discussed how many Medicare patients end up being readmitted to the hospital in part due to lack of understanding of follow-up care.
Another recent study by the Northwestern University Feinberg School of Medicine, found 78% of patients do not fully understand their discharge instructions before leaving the emergency department. To make matters worse, they found that 80% of the time patients were not even aware they did not understand their discharge instructions.
Kirsten Engel, M.D., lead study author and instructor of emergency medicine at the Feinberg School of Medicine said, “Patients who fail to follow discharge instructions may have a greater likelihood of complications after leaving the emergency department.”
The study assessed 138 patients from Anne Arbor, Michigan according to four categories of comprehension (diagnosis and cause, emergency department care, post-emergency department care and return instructions.) Fifty-one percent did not fully understand what they were told in 2 or more categories.
According to Engle, “The bottom line is that we need better strategies for identifying patients who are having difficulty understanding their care instructions in the emergency department… When you are in the emergency department, be honest and don’t be afraid to ask questions.”
It turns out understanding what you should do at home after leaving a doctor’s care is important for your recovery. Yet many patients do not fully understand their post-hospital care instructions and are not even aware of their misunderstanding.
As far as we know the study did not account for language difficulties so we assume the study participants were English speakers. Imagine what the study would find for Non-English speakers…
By Sherry Dineen
This study was published online in July of 2008 by the Annals of Emergency Medicine.
www.annemergmed.com/
Another recent study by the Northwestern University Feinberg School of Medicine, found 78% of patients do not fully understand their discharge instructions before leaving the emergency department. To make matters worse, they found that 80% of the time patients were not even aware they did not understand their discharge instructions.
Kirsten Engel, M.D., lead study author and instructor of emergency medicine at the Feinberg School of Medicine said, “Patients who fail to follow discharge instructions may have a greater likelihood of complications after leaving the emergency department.”
The study assessed 138 patients from Anne Arbor, Michigan according to four categories of comprehension (diagnosis and cause, emergency department care, post-emergency department care and return instructions.) Fifty-one percent did not fully understand what they were told in 2 or more categories.
According to Engle, “The bottom line is that we need better strategies for identifying patients who are having difficulty understanding their care instructions in the emergency department… When you are in the emergency department, be honest and don’t be afraid to ask questions.”
It turns out understanding what you should do at home after leaving a doctor’s care is important for your recovery. Yet many patients do not fully understand their post-hospital care instructions and are not even aware of their misunderstanding.
As far as we know the study did not account for language difficulties so we assume the study participants were English speakers. Imagine what the study would find for Non-English speakers…
By Sherry Dineen
This study was published online in July of 2008 by the Annals of Emergency Medicine.
www.annemergmed.com/
Understanding is Key to Staying Out of the Hospital - Part I
A recent study by the Northwestern University Feinberg School of Medicine examined the frequency of rehospitalization, the risk of readmission and the frequency of follow-up outpatient doctor visits before being discharged from the hospital. The study looked at fee-for-claims service data for roughly 12 million Medicare patients discharged from a hospital in the years 2003 and 2004.
What the study found was astounding.
One out of five Medicare patients is readmitted to the hospital. The healthcare tab for readmissions in 2004 was 17 billion dollars. More than half of the patients that are rehospitalized within 30 days did not see a physician as an outpatient after being released the first time.
The study found that the rate of readmission increases as time passes from the first hospitalization. Thirty-four percent of patients were readmitted within 90 days of release and that number increases to 56.1 percent after one year of release.
Of those readmitted, 70 percent suffered from complications that could easily have been prevented by follow-up doctor visits such as urinary tract infections or pneumonia.
The study co-author, Mark Williams, M.D., chief of hospital medicine for Northwestern’s Feinberg School of Medicine and Northwestern Memorial Hospital, commented that Medicare does not pay doctors or pharmacists to spend time with patients to make sure they understand their discharge and medication instructions when they leave the hospital. “They pay for quantity of service, not quality.” He further adds, “They [Medicare] do not target payments to improve patient understanding of their care and their need for follow-up.”
“When patients and their caregivers understand the goals of their care, they commonly get better relief from their symptoms and use less health care services at their request,” Williams said.
Creating understanding for all patients regardless of their age or language spoken is the key to reducing our country’s healthcare costs by keeping needless hospital readmissions to a minimum.
Check back on Wednesday for Part II and read about another study linking understanding with improved healthcare.
by Sherry Dineen
The study was published in the New England Journal of Medicine on April 2, 2009 and can be found using the following link:
http://content.nejm.org/cgi/content/full/360/14/1418
Mr. Williams’ comments can be found at: http://www.northwestern.edu/newscenter/stories/2009/04/medicare.html
What the study found was astounding.
One out of five Medicare patients is readmitted to the hospital. The healthcare tab for readmissions in 2004 was 17 billion dollars. More than half of the patients that are rehospitalized within 30 days did not see a physician as an outpatient after being released the first time.
The study found that the rate of readmission increases as time passes from the first hospitalization. Thirty-four percent of patients were readmitted within 90 days of release and that number increases to 56.1 percent after one year of release.
Of those readmitted, 70 percent suffered from complications that could easily have been prevented by follow-up doctor visits such as urinary tract infections or pneumonia.
The study co-author, Mark Williams, M.D., chief of hospital medicine for Northwestern’s Feinberg School of Medicine and Northwestern Memorial Hospital, commented that Medicare does not pay doctors or pharmacists to spend time with patients to make sure they understand their discharge and medication instructions when they leave the hospital. “They pay for quantity of service, not quality.” He further adds, “They [Medicare] do not target payments to improve patient understanding of their care and their need for follow-up.”
“When patients and their caregivers understand the goals of their care, they commonly get better relief from their symptoms and use less health care services at their request,” Williams said.
Creating understanding for all patients regardless of their age or language spoken is the key to reducing our country’s healthcare costs by keeping needless hospital readmissions to a minimum.
Check back on Wednesday for Part II and read about another study linking understanding with improved healthcare.
by Sherry Dineen
The study was published in the New England Journal of Medicine on April 2, 2009 and can be found using the following link:
http://content.nejm.org/cgi/content/full/360/14/1418
Mr. Williams’ comments can be found at: http://www.northwestern.edu/newscenter/stories/2009/04/medicare.html
Thursday, June 25, 2009
Culture Affects Fitness
Exercise (no surprise) and culture (surprise!) were part of the focus at the Annual Meeting of the American College of Sports Medicine in Seattle at the end of May.
As part of the research presented, one study, conducted by Rafer Lutz, Ph.D., came to the conclusion that when under stress, college women who do not exercise regularly are less likely to exercise.
According to Lutz, “Someone who isn’t regularly active may view exercise as ‘one more burden’ when stressed.”
On the other hand, the study found college women with consistent exercise levels, “accumulate more physical activity” when similarly stressed. Lutz again expounds, “those who make it [exercise] a part of daily life may view it as a stress reliever and an escape from pressure.”
A second study presented at the Annual Meeting examined exercise differences between 400 American and Chinese college students. Researchers found that Americans exercise for weight control and physical appearance, whereas the Chinese students exercised for health and enjoyment reasons.
Lead study author, Zi Yah, M.S. concluded, “Although we didn’t study the origins of these exercise motivations, it may be a reflection of cultural values and what young people are taught to prioritize about themselves.”
Expanding this connection between exercise and culture further to include older women, another study is of note. In 2005, at the Second International Conference on Women, Heart Disease and Stroke, University of California San Francisco School of Nursing researchers proposed that exercise in tune with culture creates better program compliance.
They provided a Tai Chi program to older Chinese women with at least one major risk factor for coronary heart disease. Normally exercise programs for women with heart disease have high dropout rates but the retention rate for this one was 96% and there was a waiting list for the next session.
Part of the success of the study resulted from the researchers being culturally in tune with the group. One researcher, Ms. Taylor-Piliae had spent 15 years in Hong Kong, speaks Cantonese and is familiar with the culture. "Language was not a barrier to understanding in this study," she said. "This is important."
Researchers learned that Tai Chi appears to be a form of exercise that is safe and acceptable to Chinese women. "I think the key is to find out what already is a popular form of exercise within an ethnic group. If it is safe and is equivalent to brisk walking, then it not only may be effective, but more acceptable."
As part of the research presented, one study, conducted by Rafer Lutz, Ph.D., came to the conclusion that when under stress, college women who do not exercise regularly are less likely to exercise.
According to Lutz, “Someone who isn’t regularly active may view exercise as ‘one more burden’ when stressed.”
On the other hand, the study found college women with consistent exercise levels, “accumulate more physical activity” when similarly stressed. Lutz again expounds, “those who make it [exercise] a part of daily life may view it as a stress reliever and an escape from pressure.”
A second study presented at the Annual Meeting examined exercise differences between 400 American and Chinese college students. Researchers found that Americans exercise for weight control and physical appearance, whereas the Chinese students exercised for health and enjoyment reasons.
Lead study author, Zi Yah, M.S. concluded, “Although we didn’t study the origins of these exercise motivations, it may be a reflection of cultural values and what young people are taught to prioritize about themselves.”
Expanding this connection between exercise and culture further to include older women, another study is of note. In 2005, at the Second International Conference on Women, Heart Disease and Stroke, University of California San Francisco School of Nursing researchers proposed that exercise in tune with culture creates better program compliance.
They provided a Tai Chi program to older Chinese women with at least one major risk factor for coronary heart disease. Normally exercise programs for women with heart disease have high dropout rates but the retention rate for this one was 96% and there was a waiting list for the next session.
Part of the success of the study resulted from the researchers being culturally in tune with the group. One researcher, Ms. Taylor-Piliae had spent 15 years in Hong Kong, speaks Cantonese and is familiar with the culture. "Language was not a barrier to understanding in this study," she said. "This is important."
Researchers learned that Tai Chi appears to be a form of exercise that is safe and acceptable to Chinese women. "I think the key is to find out what already is a popular form of exercise within an ethnic group. If it is safe and is equivalent to brisk walking, then it not only may be effective, but more acceptable."
Thursday, June 18, 2009
Risky Business
The FDA’s latest draft Industry Guidance paper addresses how drug companies should present risk information in ads for prescription drugs and medical devices. It is meant to illustrate factors the FDA considers when evaluating ads and labeling for drugs and devices for compliance to relevant regulations. It delves into the mind of the consumer and provides examples on how companies should present risk information.
Risk information is critical to both health professionals and consumers and needs to be clearly communicated to its target audience. According to the FDA, omission or minimization of risk information is the most common violation of regulations for product advertising and promotion. They also claim research in Direct to Consumer (DTC) prescription drug advertising has shown that:
- “60 percent of patients believe ads directed at them do not provide enough information about risks”
- “60 percent of physicians believe that patients have little or no understanding from these ads about what the possible risks and negative effects of the products are” and
- “72 percent of physicians believe that patients have little or no understanding from these ads about who should not use the product”
To comply with regulations ads cannot be false or misleading, they must reveal facts about the product and consequences from its use and they must present benefits and risks in a balanced manner. In other words, you can’t play up the drug’s benefits while downplaying its risks.
When evaluating a promotional piece, the FDA evaluates the net impression communicated by all the elements of the piece. It does so using “well-developed social science principles supported by decades of scientific research.” They use science to figure out how we understand best.
For example, the FDA explains how research indicates when people process a list of text they are better able to recall items at the beginning or end of the list. So ads should not insert important risk information in the middle of reams of text.
They also discuss how cognitive load, or the mental effort required to take in information, is affected by the amount of information presented and in what way. Word choice, loud colors and busy graphics can be distracting or put more emphasis on one piece of information versus another.
The bottom line from the guidance paper is that drug and device communications need to present risk and benefit information in a balanced manner and in language that is clear for its target audience.
A Wall Street Journal article reported that drug makers “remain committed to producing responsible, balanced promotional materials” and have adopted voluntary guidelines that say risks “should be presented in clear, understandable language without distraction.” via a PhRMA spokesperson.
Thursday, June 11, 2009
Sales, Science and CME
Pharmaceutical sales reps are taking advantage of the same Continuing Medical Education (CME) programs usually offered exclusively to healthcare providers. By obtaining a broader understanding of the science that supports and differentiates their company’s products, sales reps hope to differentiate themselves from their competitors.
The idea seems to have merit. So far, one pharmaceutical company has determined that their sales reps should be accredited and has teamed up with the American Society of Hypertension (ASH). Beginning this summer, Daiichi Sankyo will be sending sales teams to a Hypertension Accreditation Program designed to improve their understanding of hypertension and related cardiovascular diseases.
The idea of CME training for pharmaceutical sales reps is not a new idea, although in the past, the content of such training was largely centered on the regulatory and compliance issues that directed the interaction between sales representatives and healthcare providers.
While our global economy is experiencing a downturn, pharmaceutical company leaders are optimistic about the future. Part of that confidence, it seems, comes from the idea of a smaller, but scientifically savvy, sales force. Beginning with the recruitment of medically competent candidates, and then providing continuing medical education, the name of the game to stay ahead is differentiation.
In an industry experiencing tremendous shifts - from the path of product development to new avenues in marketing - competition for market share is intense. CME accreditation could be another way for a company to set itself apart from the field. But, with more knowledgeable sales teams leading to stronger communication with healthcare providers, the patient’s health is ultimately better for it.
by Audrey Miller
The idea seems to have merit. So far, one pharmaceutical company has determined that their sales reps should be accredited and has teamed up with the American Society of Hypertension (ASH). Beginning this summer, Daiichi Sankyo will be sending sales teams to a Hypertension Accreditation Program designed to improve their understanding of hypertension and related cardiovascular diseases.
“Physicians prefer to interact with well-informed pharmaceutical sales representatives who not only understand the company’s products, but have a keen appreciation for the disease and underlying science.” - Henry R. Black, MD, President of ASH
The idea of CME training for pharmaceutical sales reps is not a new idea, although in the past, the content of such training was largely centered on the regulatory and compliance issues that directed the interaction between sales representatives and healthcare providers.
While our global economy is experiencing a downturn, pharmaceutical company leaders are optimistic about the future. Part of that confidence, it seems, comes from the idea of a smaller, but scientifically savvy, sales force. Beginning with the recruitment of medically competent candidates, and then providing continuing medical education, the name of the game to stay ahead is differentiation.
In an industry experiencing tremendous shifts - from the path of product development to new avenues in marketing - competition for market share is intense. CME accreditation could be another way for a company to set itself apart from the field. But, with more knowledgeable sales teams leading to stronger communication with healthcare providers, the patient’s health is ultimately better for it.
by Audrey Miller
Wednesday, June 3, 2009
Tuesday, June 2, 2009
¿Comprendes?
Please read the following information carefully as it pertains to the medication prescribed to your child:
Para recibir la cantidad correcta de medicamento es indispensable cebar el inhalador. Cébelo antes de usarlo por primera vez o cuando no lo haya usado durante más de 14 días. Para cebarlo, quítele la tapa a la boquilla del disparador. Después, agite bien el inhalador y haga una pulverización al aire, lejos de su rostro. Para terminar de cebarlo, haga otras dos agitaciones y pulverizaciones de esta forma.
So, if you only speak English, do you now know how to give your child his or her medication? How does this make you feel right now? Confused? Angry? Concerned? Imagine being a non-English speaker and this is how the piece of paper stapled to your prescription medication reads:
You must prime the inhaler to get the right amount of medicine. Prime the inhaler before you use it for the first time or if you have not used it for more than 14 days. To prime the inhaler, take the cap off the mouthpiece of the actuator. Then shake the inhaler well and spray it into the air away from your face. Shake and spray the inhaler like this 2 more times to finish priming it.
Filling a prescription may not help you if you are unable to understand when or how to take it. The leading cause of medication errors is patient misunderstanding of prescription drug label instructions.
A new study from Northwestern University surveyed pharmacies in Texas, Colorado, Georgia and North Carolina where there are large Latino populations. Of the 764 pharmacies, only 43.3% could offer instructions in Spanish. 21.7% offered some translation services and 34.9% offered no services.
Most pharmacies offer none or limited translation services and not just in rural areas or those with small Latino populations. The conclusion of the study was that “Spanish-speaking patients encounter barriers to acquiring instructions that support the safe and effective use of medications.”
Should knowing how to take your medication properly be limited to persons who only speak English? That seems rather discriminatory. In a country where we have so much, is being able to read your prescription medication instructions too much to ask?
Para recibir la cantidad correcta de medicamento es indispensable cebar el inhalador. Cébelo antes de usarlo por primera vez o cuando no lo haya usado durante más de 14 días. Para cebarlo, quítele la tapa a la boquilla del disparador. Después, agite bien el inhalador y haga una pulverización al aire, lejos de su rostro. Para terminar de cebarlo, haga otras dos agitaciones y pulverizaciones de esta forma.
So, if you only speak English, do you now know how to give your child his or her medication? How does this make you feel right now? Confused? Angry? Concerned? Imagine being a non-English speaker and this is how the piece of paper stapled to your prescription medication reads:
You must prime the inhaler to get the right amount of medicine. Prime the inhaler before you use it for the first time or if you have not used it for more than 14 days. To prime the inhaler, take the cap off the mouthpiece of the actuator. Then shake the inhaler well and spray it into the air away from your face. Shake and spray the inhaler like this 2 more times to finish priming it.
Filling a prescription may not help you if you are unable to understand when or how to take it. The leading cause of medication errors is patient misunderstanding of prescription drug label instructions.
A new study from Northwestern University surveyed pharmacies in Texas, Colorado, Georgia and North Carolina where there are large Latino populations. Of the 764 pharmacies, only 43.3% could offer instructions in Spanish. 21.7% offered some translation services and 34.9% offered no services.
Most pharmacies offer none or limited translation services and not just in rural areas or those with small Latino populations. The conclusion of the study was that “Spanish-speaking patients encounter barriers to acquiring instructions that support the safe and effective use of medications.”
Should knowing how to take your medication properly be limited to persons who only speak English? That seems rather discriminatory. In a country where we have so much, is being able to read your prescription medication instructions too much to ask?
Thursday, May 28, 2009
Outsourcing Clinical Trials: Up for Debate
The ethics of pharmaceutical companies conducting late-stage human drug trials overseas is the hot topic of the day. An article published today by a few researchers from Duke University in the New England Journal of Medicine has sparked a debate among the big guns: the Wall Street Journal, the New York Times, CNN, Triangle Business Journal, HealthDay, even the FDA is chiming in.
A point of debate includes whether drug research in other countries where there may be genetic variations (such as in East Asia where the physical reaction to nitroglycerin varies) is relevant to American populations. It is questioned whether a trial for fibromyalgia for instance, is even needed in a country where tuberculosis is the norm. Lack of foreign oversight by institutional review boards, adequately discussed informed consents for subjects, and unfair financial inducements to subjects are some of the other points of discussion. The author’s research methods are also under fire.
Right or wrong, the best way to conduct ethical overseas drug trials is to ensure the rights of the trial subjects. This needs to happen through clear and concise communication with patients. Their rights are protected and the integrity of the pharmaceutical industry is preserved only when they are able to fully understand the process they are undertaking.
To ensure clear and concise communications overseas, a top-quality language vendor who specializes in medical and life science translation must be utilized. Not only do we provide translations performed by professional linguists with advanced degrees in medicine, biology, chemistry and pharmacology, aiaTranslations also has a new product, REEL CONSENTTM, an instructional video designed to provide improve enrollment and consent quality in non-English speaking and low literacy populations.
To see the original article by the New England Journal of Medicine, click the link below:
http://content.nejm.org/cgi/content/full/360/8/816
Reaction articles include:
CNN.com
http://www.cnn.com/2009/HEALTH/02/18/outsourced.trials/index.html
HealthDay
http://www.healthday.com/Article.asp?AID=624242
Triangle Business Journal
http://triangle.bizjournals.com/triangle/stories/2009/02/16/daily42.html
Go to www.wsj.com and www.nytimes.com to see responses from the Wall Street Journal and the New York Times.
A point of debate includes whether drug research in other countries where there may be genetic variations (such as in East Asia where the physical reaction to nitroglycerin varies) is relevant to American populations. It is questioned whether a trial for fibromyalgia for instance, is even needed in a country where tuberculosis is the norm. Lack of foreign oversight by institutional review boards, adequately discussed informed consents for subjects, and unfair financial inducements to subjects are some of the other points of discussion. The author’s research methods are also under fire.
Right or wrong, the best way to conduct ethical overseas drug trials is to ensure the rights of the trial subjects. This needs to happen through clear and concise communication with patients. Their rights are protected and the integrity of the pharmaceutical industry is preserved only when they are able to fully understand the process they are undertaking.
To ensure clear and concise communications overseas, a top-quality language vendor who specializes in medical and life science translation must be utilized. Not only do we provide translations performed by professional linguists with advanced degrees in medicine, biology, chemistry and pharmacology, aiaTranslations also has a new product, REEL CONSENTTM, an instructional video designed to provide improve enrollment and consent quality in non-English speaking and low literacy populations.
To see the original article by the New England Journal of Medicine, click the link below:
http://content.nejm.org/cgi/content/full/360/8/816
Reaction articles include:
CNN.com
http://www.cnn.com/2009/HEALTH/02/18/outsourced.trials/index.html
HealthDay
http://www.healthday.com/Article.asp?AID=624242
Triangle Business Journal
http://triangle.bizjournals.com/triangle/stories/2009/02/16/daily42.html
Go to www.wsj.com and www.nytimes.com to see responses from the Wall Street Journal and the New York Times.
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