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

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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.

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References

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

  2. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 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.

    Article  Google Scholar 

  4. 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.

  5. 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.

  6. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia

    Rawan Sawalha

  2. Heart and Stroke Program, Hunter Medical Research Institute, NSW, Australia

    Beata Bajorek

  3. Hunter New England Local Health District, New Lambton, NSW, Australia

    Beata Bajorek

  4. School of Health and Society, University of Wollongong, Wollongong, NSW, Australia

    Hassan Hosseinzadeh

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Sawalha, R., Hosseinzadeh, H. & Bajorek, B. Culturally and linguistically diverse patients’ perspectives and experiences on medicines management in Australia: a systematic review. Int J Clin Pharm 45, 814–829 (2023). https://doi.org/10.1007/s11096-023-01560-6

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