As some people age, they may have trouble reading prescription labels, knowing what dose to take and identifying proper pills.
Mistakes can have life-threatening consequences. The challenge is exacerbated for folks who don’t see well or have a severe visual impairment though some blind people have learned to figure out which pill is which by feeling its shape or texture.
Let the label do the talking
Many pharmacies are introducing other options that promise to be far more reliable: letting a prescription label tell you what’s in the bottle, including drug names, dosage, warnings and other information. More precisely, you’ll hear the words read aloud through a standalone speaker — or your iPhone or Android handset via an app.
“I would like to see this become ubiquitous across the pharmacy landscape,” says Eric Bridges, executive director of the American Council of the Blind in Arlington, Virginia.
In collaboration with the nonprofit, CVS Health recently announced a proprietary talking prescription label solution called Spoken Rx is now available in its nearly 10,000 retail pharmacies in the U.S., including CVS locations in Target. CVS tested the labels in a smaller number of stores last year. The labels are made available for some mail order prescriptions as well in English or Spanish.
Spoken Rx is similar to the ScripTalk audio labels from Palmetto, Florida-based En-Vision America, with origins dating to the early 2000s, when the U.S. Department of Veterans Affairs used them. ScripTalk was subsequently adopted by Walmart/Sam’s Club and numerous other pharmacies including H-E-B, Hy-Vee, Kaiser Permanente, Rite Aid, Publix and Winn-Dixie. It also is available with certain mail order prescriptions.
The government has been encouraging accessible prescription labels for some time, but progress has been slow. In July 2012, President Obama signed a bill into law calling for the U.S. Food & Drug Administration to enable "best practices for pharmacies to ensure that blind and visually-impaired individuals have safe, consistent, reliable, and independent access to the information on prescription drug container labels."
Nearly four and a half years later, the U.S. Government Accountability Office found that prescriptions dispensed with accessible labels — including audible, braille and large print formats — still made up less than 1 percent of labels, and that actions were needed to bolster awareness of best practices. In a 2018 government health survey, about 13 percent of all adult Americans said they were blind or had trouble seeing even when wearing corrective lenses.
Enrollment is required
You must enroll for either talking label solution by calling or visiting your local pharmacy. The apps or a device to hear the labels are free at participating pharmacies, and you won’t pay extra for your prescriptions.
A pharmacist affixes an electronic tag to the bottom of each pill bottle. This talking label, based on radio-frequency identification (RFID) technology, can read back most if not all the instructions printed on the conventional label.
You can access the Spoken Rx tool inside the Pharmacy section of the CVS Pharmacy app. When you tap the icon and then hold a tagged prescription within 4 inches of your phone, you’ll hear everything read out loud in a synthesized computer voice. To avoid confusion, the full drug name is read with no abbreviations, says Jared Tancrelle, senior vice president of retail operations at CVS Health.
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ScripTalk has its own free dedicated app, in addition to a free battery-operated ScripTalk Station, which is about the size of an old portable CD player. ScripTalk Station has a wheel that lets you turn it on and adjust the volume, along with tactile buttons for playing the audio, skipping through the information or jumping back.
You have two options if you use the ScripTalk mobile app: selecting an onscreen Full Scan button at the top of the app or a Quick Scan button. The Full Scan button reads everything on the label, including drug name, dosage, warnings, refill info. The Quick Scan button will read only the prescription name and dosage.
With an iPhone facing up, you typically place the medication bottle with the sticker facing down on the top of the screen. On Android, you will instead place the phone face down and the bottom of the bottle on the backside of the handset.
The phone will read the electronic tag, though you may have to move the bottle around before the app starts reading the label. Indeed, to use any smartphone app, a blind person must be somewhat proficient in use of accessibility tools on the device to open the app and determine where to tap.
Not for over-the-counter drugs
One drawback to these talking RFID labels is that they’re generally used for prescriptions only, and not for over-the-counter drugs.
“This one area of our advocacy has been the most challenging,” Bridges says. “Obviously, we wanted to focus first on prescription drugs because they’re the most critical to our own health.”
Neva Fairchild, national aging and vision loss specialist at the American Foundation for the Blind (AFB), uses the CVS app and sometimes braille labels for prescription drugs.
“You’d be amazed how much an ibuprofen feels like an iron pill feels like an allergy pill,” she says.
Other companies offer additional solutions. Walgreens stores have a Talking Pill Reminder that is free for people who self-identify as visually impaired. It costs about $10 otherwise.
Dosing directions and label information that a pharmacist records are played back when you push a button on a Talking Pill Reminder, which attaches to the bottom of most prescription vials. It can record up to a 30-second description.
The Seeing AI app for the iPhone from Microsoft can read aloud the short text it sees in front of the phone’s camera, including what appears on a prescription bottle. The versatile app has other functions, such as identifying people and the denominations on currencies.
“The reason I find [Seeing AI] particularly useful is you don’t have to specifically know where the text is if you’re trying to scan a pill bottle,” Aaron Preece says. He's editor-in-chief of AccessWorld, AFB’s technology magazine.
An extra set of eyes
But some people want to hear from a human being who can assist them in real time. For example, the free Be My Eyes app connects a blind person with a sighted volunteer from around the world who can read the label on his or her behalf. Through a live video connection, the sighted person tells the visually impaired individual how to position the smartphone camera so the sighted person can report what he or she sees.
“We have 5.4 million people who are ready to read a label any time you need it,” says Will Butler, chief experience officer at Be My Eyes. But “we have to be a little bit careful that we’re not connecting people with strangers who help them manage their prescriptions. Our terms of service are pretty clear about not using Be My Eyes for anything that could be unsafe.”
If you need more than just a label read, Be My Eyes lets you call into a participating specialized pharmacy through the app, notably Accessible Pharmacy Services and Rite Aid. To get there, you open the Be My Eyes app, enter the Specialized Help menu and locate the pharmacy in the Personal Health category.
Be My Eyes is similar to a “visual interpreting” service called Aira from Aira Tech Corp in Carlsbad, California. The main difference: All the human agents a blind person connects with on Aira are professionally trained. On Be My Eyes, the only ones who are professionally trained are the Specialized Help agents who represent specific companies.
Customers get up to five minutes a day with the Aira agent for free, which might be all they need to identify the medications they’re taking. If the need arises, you can pay for additional minutes with plans that start at $29 for up to a half hour.
“A lot of people will use us for their prescription labels,” says Jenine Stanley, director of customer communication at Aira. “The other thing that they use it for is, 'I dropped this pill and I have no idea what it is,' or 'I found this pill in the drawer and have no idea what it is.' Our agents can take a picture of that pill, blow it up to see the number on it or any writing and go out and research that.”
Agents are bonded and must sign confidentiality agreements so that the low-vision person’s information is kept private and secure.
Edward C. Baig is a contributing writer who covers technology and other consumer topics. He previously worked for USA Today, BusinessWeek, U.S. News & World Report and Fortune and is the author of Macs for Dummies and the coauthor of iPhone for Dummies and iPad for Dummies.
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