Top

International Journal of Clinical Pharmacy

Published in:

05-04-2023 | Review Article

Culturally and linguistically diverse patients’ perspectives and experiences on medicines management in Australia: a systematic review

Authors: Rawan Sawalha, Hassan Hosseinzadeh, Beata Bajorek

Published in: International Journal of Clinical Pharmacy | Issue 4/2023

Abstract

Background

Within the quality use of medicines (QUM)—which entails timely access to, and the rational use of, medicines—medicine safety is a global health priority. In multicultural countries, such as Australia, national medicines policies are focused on achieving QUM, although this is more challenging among their Culturally and Linguistically Diverse (CALD) patients (i.e., those from ethnic minority groups).

Aim

This review aimed to identify and explore the specific challenges to achieving QUM, as experienced by CALD patients living in Australia.

Method

A systematic literature search was conducted using Web of Science, Scopus, Academic search complete, CINHAL, PubMed and Medline. Qualitative studies describing any aspects of QUM among CALD patients in Australia were included.

Results

Major challenges in facilitating QUM among CALD patients in Australia were identified, particularly in relation to the following medicines management pathway steps: difficulties around participation in treatment decision-making alongside deficiencies in information provision about medicines. Furthermore, medication non-adherence was commonly observed and reported. When mapped against the bio-psycho-socio-systems model, the main contributors to the medicine management challenges identified related to “social” and “system” factors, reflecting the current health-system’s lack of capacity and resourcing to respond to patients’ low health literacy levels, communication and language barriers, and cultural and religious perceptions about medicines.

Conclusion

QUM challenges were different among different ethnic groups. This review suggests a need to engage with CALD patients in co-designing culturally appropriate resources and/or interventions to enable the health-system to address the identified barriers to QUM.

Available only for authorised users

Pharmaceutical Society of Australia. 2019. https://www.psa.org.au/medicine-safety-to-be-the-10th-national-health-priority-area/. Accessed 21 Jan 2023.

McLachlan AJ, Aslani P. National Medicines Policy 2.0: a vision for the future. Aust Prescr. 2020;43(1):24–6. https://doi.org/10.18773/austprescr.2020.007.CrossRefPubMedPubMedCentral

Nørgaard L, Cantarero-Arévalo L, Håkonsen H. The meeting between ethnic minorities, medicine use and the Nordic countries: an overview of theory-based intervention studies and lessons learned. Res Social Adm Pharm. 2017;13:e5. https://doi.org/10.1016/j.sapharm.2017.02.073.CrossRef

Pearson SA, Pratt N, de Oliveira Costa J, et al. Generating real-world evidence on the quality use, benefits and safety of medicines in Australia: History, challenges and a roadmap for the future. Int J Environ Res Public Health. 2021;18(24):13345. https://doi.org/10.3390/ijerph182413345.

Bates DW. Preventing medication errors: a summary. Am J Health Syst Pharm. 2007;64(14 Suppl 9):S3–9; quiz S24–6. https://doi.org/10.2146/ajhp070190.

Chauhan A, Walton M, Manias E, et al. The safety of health care for ethnic minority patients: a systematic review. Int J Equity Health. 2020;19(1):118. https://doi.org/10.1186/s12939-020-01223-2.CrossRefPubMedPubMedCentral

Gordon KJ, Smith FJ, Dhillon S. The development and validation of a screening tool for the identification of patients experiencing medication-related problems. Int J Pharm Pract. 2005;13(3):187–93. https://doi.org/10.1211/ijpp.13.3.0004.CrossRef

Stowasser DA, Allinson YM, O’Leary M. Understanding the medicines management pathway. J Pharm Pract Res. 2004;34(4):293–6. https://doi.org/10.1002/jppr2004344293.CrossRef

Pham TTL, Berecki-Gisolf J, Clapperton A, et al. Definitions of culturally and linguistically diverse (CALD): a literature review of epidemiological research in Australia. Int J Environ Res Public Health. 2021;18(2):737. https://doi.org/10.3390/ijerph18020737.CrossRefPubMedPubMedCentral

10.

Singh M, de Looper M. Australian health inequalities: birthplace. Canberra: AIHW; 2002.

11.

Australian Bureau of Statistics (ABS). Census reveals a fast changing, culturally diverse nation 2016. https://www.abs.gov.au/ausstats/abs@.nsf/lookup/Media%20Release3. Accessed 21 Jan 2023.

12.

Schwappach DL, Meyer Massetti C, Gehring K. Communication barriers in counselling foreign-language patients in public pharmacies: threats to patient safety? Int J Clin Pharm. 2012;34(5):765–72. https://doi.org/10.1007/s11096-012-9674-7.CrossRefPubMed

13.

Herrera H, Alsaif M, Khan G, et al. Provision of bilingual dispensing labels to non-native english speakers: an exploratory study. Pharmacy (Basel). 2019;7(1):32. https://doi.org/10.3390/pharmacy7010032.CrossRefPubMed

14.

Alhomoud F, Dhillon S, Aslanpour Z, et al. Medicine use and medicine-related problems experienced by ethnic minority patients in the United Kingdom: a review. Int J Pharm Pract. 2013;21(5):277–87. https://doi.org/10.1111/ijpp.12007.CrossRefPubMed

15.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71.CrossRefPubMedPubMedCentral

16.

Saleem A, Steadman KJ, Fejzic J. Utilisation of healthcare services and medicines by Pakistani migrants residing in high income countries: a systematic review and thematic synthesis. J Immigr Minor Health. 2019;21(5):1157–80. https://doi.org/10.1007/s10903-018-0840-4.CrossRefPubMed

17.

Sattar R, Lawton R, Panagioti M, et al. Meta-ethnography in healthcare research: a guide to using a meta-ethnographic approach for literature synthesis. BMC Health Serv Res. 2021;21(1):50. https://doi.org/10.1186/s12913-020-06049-w.CrossRefPubMedPubMedCentral

18.

Bunge M. How does it work?: The search for explanatory mechanisms. Philos Soc Sci. 2004;34(2):182–210. https://doi.org/10.1177/0048393103262550.CrossRef

19.

Buchman DZ, Skinner W, Illes J. Negotiating the relationship between addiction, ethics, and brain science. AJOB Neurosci. 2010;1(1):36–45. https://doi.org/10.1080/21507740903508609.CrossRefPubMedPubMedCentral

20.

Critical Appraisal Skills Programme. CASP (Qualitative) Checklist 2018. https://casp-uk.net/casp-tools-checklists/. Accessed 22 Jan 2023.

21.

Quine S. Health concerns and expectations of Anglo and ethnic older Australians: a comparative approach. J Cross Cult Gerontol. 1999;14(2):97–111. https://doi.org/10.1023/a:1006616230564.CrossRefPubMed

22.

White L, Klinner C. Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review. Aust J Prim Health. 2012;18(1):50–5. https://doi.org/10.1071/PY10099.CrossRefPubMed

23.

Bolton P, Hammoud S, Leung J. Issues in Quality use of medicines in two non-english speaking background communities. Aust J Prim Health. 2002;8(3):75–80. https://doi.org/10.1071/PY02046.CrossRef

24.

Blennerhassett J, Hilbers J. Medicine management in older people from non-english speaking backgrounds. J Pharm Pract Res. 2011;41(1):33–6. https://doi.org/10.1002/j.2055-2335.2011.tb00063.x.CrossRef

25.

Shaw J, Zou X, Butow P. Treatment decision making experiences of migrant cancer patients and their families in Australia. Patient Educ Couns. 2015;98(6):742–7. https://doi.org/10.1016/j.pec.2015.01.012.CrossRefPubMed

26.

Williams A, Manias E, Cross W, et al. Motivational interviewing to explore culturally and linguistically diverse people’s comorbidity medication self-efficacy. J Clin Nurs. 2015;24(9–10):1269–79. https://doi.org/10.1111/jocn.12700.CrossRefPubMed

27.

O’Callaghan C, Quine S. How older Vietnamese Australian women manage their medicines. J Cross Cult Gerontol. 2007;22(4):405–19. https://doi.org/10.1007/s10823-007-9045-3.CrossRefPubMed

28.

Alzayer R, Chaar B, Basheti I, et al. Asthma management experiences of Australians who are native Arabic speakers. J Asthma. 2018;55(7):801–10. https://doi.org/10.1080/02770903.2017.1362702.CrossRefPubMed

29.

Alzubaidi H, Mc Mamara K, Chapman C, et al. Medicine-taking experiences and associated factors: comparison between Arabic-speaking and Caucasian English-speaking patients with Type 2 diabetes. Diabet Med. 2015;32(12):1625–33. https://doi.org/10.1111/dme.12751.CrossRefPubMed

30.

Almansour H, Chaar B, Saini B. Perspectives and experiences of patients with type 2 diabetes observing the Ramadan fast. Ethn Health. 2016;23:1–17. https://doi.org/10.1080/13557858.2016.1269156.CrossRef

31.

Ahmad A, Khan M, Aslani P. A Qualitative Study on Medication Taking Behaviour Among People With Diabetes in Australia. Front Pharmacol. 2021;12:1–10. https://doi.org/10.3389/fphar.2021.693748.CrossRef

32.

Bellamy K, Ostini R, Martini N, et al. Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia. Int J Pharm Pract. 2017;25(5):358–64. https://doi.org/10.1111/ijpp.12324.CrossRefPubMed

33.

Mohammad A, Saini B, Chaar BB. Exploring culturally and linguistically diverse consumer needs in relation to medicines use and health information within the pharmacy setting. Res Social Adm Pharm. 2015;11(4):545–59. https://doi.org/10.1016/j.sapharm.2014.11.002.CrossRefPubMed

34.

Clark A, Gilbert A, Rao D, et al. “Excuse me, do any of you ladies speak English?” Perspectives of refugee women living in South Australia: barriers to accessing primary health care and achieving the Quality Use of Medicines. Aust J Prim Health. 2014;20(1):92–7. https://doi.org/10.1071/PY11118.CrossRefPubMed

35.

Whittaker A, Lohm D, Lemoh C, et al. Investigating understandings of antibiotics and antimicrobial resistance in diverse ethnic communities in Australia: findings from a qualitative study. Antibiotics (Basel). 2019;8(3):135. https://doi.org/10.3390/antibiotics8030135.

36.

El Samman F, Chaar BB, McLachlan AJ, et al. Medicines and disease information needs of older Arabic-speaking Australians. Australas J Ageing. 2013;32(1):28–33. https://doi.org/10.1111/j.1741-6612.2012.00587.x.CrossRefPubMed

37.

Alzubaidi H, Marriott J. Patient involvement in social pharmacy research: Methodological insights from a project with Arabic-speaking immigrants. Res Social Adm Pharm. 2014;10(6):924–25. https://doi.org/10.1016/j.sapharm.2014.08.008.

38.

Abdelmessih E, Simpson MD, Cox J, et al. Exploring the health care challenges and health care needs of arabic-speaking immigrants with cardiovascular disease in Australia. Pharmacy (Basel). 2019;7(4):151. https://doi.org/10.3390/pharmacy7040151.CrossRefPubMed

39.

Malhotra R, Bautista MAC, Tan NC, et al. Bilingual text with or without pictograms improves elderly Singaporeans’ understanding of prescription medication labels. Gerontologist. 2019;59(2):378–90. https://doi.org/10.1093/geront/gnx169.CrossRefPubMed

40.

Shnaigat M, Downie S, Hosseinzadeh H. Effectiveness of health literacy interventions on COPD self-management outcomes in outpatient settings: a systematic review. COPD. 2021;18(3):367–73. https://doi.org/10.1080/15412555.2021.1872061.CrossRefPubMed

41.

Culhane-Pera KA, Pergament SL, Kasouaher MY, et al. Diverse community leaders’ perspectives about quality primary healthcare and healthcare measurement: qualitative community-based participatory research. Int J Equity Health. 2021;20(1):226. https://doi.org/10.1186/s12939-021-01558-4.CrossRefPubMedPubMedCentral

42.

Youssef J, Deane FP. Arabic-speaking religious leaders’ perceptions of the causes of mental illness and the use of medication for treatment. Aust N Z J Psychiatry. 2013;47(11):1041–50. https://doi.org/10.1177/0004867413499076.CrossRefPubMed

43.

Kirkpatrick CMJ, Roughead EE, Monteith GR, et al. Consumer involvement in quality use of medicines (QUM) projects – lessons from Australia. BMC Health Serv Res. 2005;5(1):75. https://doi.org/10.1186/1472-6963-5-75.CrossRefPubMedPubMedCentral

Title: Culturally and linguistically diverse patients’ perspectives and experiences on medicines management in Australia: a systematic review
Authors: Rawan Sawalha
Hassan Hosseinzadeh
Beata Bajorek
Publication date: 05-04-2023
Publisher: Springer International Publishing
Published in: International Journal of Clinical Pharmacy / Issue 4/2023
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-023-01560-6

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2023

Impact of a primary care pharmacist consultations on pregnant women’s medication use: the SafeStart intervention study linked to a national prescription database

Comparison of prioritisation algorithms for the selection of patients for medication reviews in the emergency department: a cross-sectional study

Venous thromboembolism recurrence among one-and-done direct oral anticoagulant users: a retrospective longitudinal study

Antimicrobial utilization and resistance in Pseudomonas aeruginosa using segmented regression analysis: a comparative study between Serbia and eight European Countries

Evaluating the potential outcomes of pharmacist-led activities in the Australian general practice setting: a prospective observational study

Factors that influence patient and public adverse drug reaction reporting: a systematic review using the theoretical domains framework

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials