Assessing the Impact of Language Access Regulations on the Provision of Pharmacy Services

Exploring Pharmacist Roles in Telepharmacy for Chronic Disease Management in New York State: A Qualitative Inquiry into Improving Implementation, Patient Communication, and Healthcare Technology Support

Background This qualitative study aimed to collect information regarding pharmacists' roles in telepharmacy and chronic disease management (CDM). The literature review was conducted on historical overview, CDM overview, social determinants of health (SDOH), disparities, hospital readmissions, adverse drug events, best practices, and global implications of telepharmacy. Materials and methods Eleven licensed pharmacists from New York working in retail or hospital settings were interviewed using 16 questions. The interview covered topics such as CDM, hospital readmissions, adverse drug events, best practices, SDOH, and health disparities. The recordings of these interviews were transcribed and coded for each open-ended question, resulting in 136 different codes. Results According to the comprehensive review of interview transcripts, there is still an urgent need for communication between healthcare providers and patients, pharmacist training for telepharmacy services and SDOH, and healthcare technology support. CDM can be advanced by pharmacists by understanding patient barriers, SDOHs, health disparities, and pill burdens, as well as incorporating a multidisciplinary approach to patient care. Pharmacists must facilitate open communication, overcome technological barriers, seek support from stakeholders for telepharmacy training, and integrate new mobile applications to improve telepharmacy implementation and operations for providing interventions. Conclusion The research provides insights into the comprehensive impact of telepharmacy on healthcare delivery and its potential to transform CDM. With the expansion of telepharmacy, individuals living with chronic diseases can experience improved medication adherence and overall health outcomes.

From refugee to pharmacist: Insights for better care

PURPOSE

This reflection utilizing Gibb's model offers insight into the lived experience of a Vietnamese child refugee who, many years later, found herself working as a pharmacist with Afghan refugees.

DESCRIPTION

Through this piece, the author describes her childhood experience with the United States (US) healthcare system as a refugee, her experience as a pharmacist caring for refugees, and explores her thoughts and feelings about the experience.

ANALYSIS/INTERPRETATION

The author evaluates the positive and negative aspects of the situation and analyzes the experience to make sense of the situation.

CONCLUSIONS

After reflecting on what she learned through her experience combined with findings in the literature, the author offers recommendations to pharmacists as they care for refugees, emphasizing the need for trauma-informed care for refugees with limited English language skills who are trying to navigate the complex US healthcare system.

IMPLICATIONS

This piece offers insights for pharmacists caring for refugees on how to offer better care.

Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review

BACKGROUND

Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction.

OBJECTIVE

The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries.

METHODS

A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria.

RESULTS

A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building.

CONCLUSIONS

While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..

Development of a Spanish-language drug facts label prototype for a combination mifepristone and misoprostol medication abortion product

OBJECTIVE

To develop a Spanish-language drug facts label prototype for medication abortion.

STUDY DESIGN

We translated a drug facts label prototype for medication abortion and conducted cognitive video interviews with reproductive age native Spanish speakers to assess and improve its readability.

RESULTS

Thirty-eight people ages 15 to 48 completed cognitive interviews, found the drug facts label easy to understand and suggested minor improvements.

CONCLUSION

Conducting cognitive interviews with native Spanish speakers is a helpful tool to improve readability of a translated label.

IMPLICATIONS

This drug facts label can help to ensure that Spanish speakers have access to easy-to-understand instructions of how to take medication abortion without clinical supervision.

Serving underserved Hispanic populations: Practical strategies for pharmacy professionals

As pharmacy professionals and health care systems serve diverse patient populations, especially in continued efforts to reduce the spread of coronavirus disease 2019, racial and ethnic disparities must be acknowledged and addressed. The authors share a collaboration between a nonprofit immunization coalition and college of pharmacy to provide mobile coronavirus disease 2019 vaccination clinics to communities across Idaho that have been disproportionately affected by the pandemic. The goal of this commentary is to share experiences providing vaccination services for the Hispanic community and discuss strategies for pharmacy professionals to provide more equitable care. Through clinical experience and listening sessions to address vaccine hesitancy, several themes emerged that could be categorized into the following: convenience, complacency, and confidence. Suggestions to overcome vaccine hesitancy include hosting events at work sites, bilingual communication techniques, targeted education, and collaboration with trusted community partners. Additional considerations in implementing more equitable care include creating a culturally competent workforce, combatting vaccine misinformation, and finding sustainable ways to continue community partnerships to provide ongoing and expanding services. Utilizing unique approaches to serve the stated needs of a Hispanic population is essential to providing equitable health care to all members of a community.

Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person-centred codesign study

INTRODUCTION

Medicines-centred consultations are vital to support medicine effectiveness and optimize health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking; this study will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities.

METHODS

A series of codesign workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call (adhering to COVID-19 restrictions). Existing evidence-based perceptions affecting access to medicines advice were critiqued and recommendations were generated, by use of reflexive thematic analysis, to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim. QSR NVivo (Version 12) facilitated data analysis.

RESULTS

Twelve participants were recruited using purposive sampling; including eight UK citizens, two asylum seekers and two participants in receipt of residency visas. In total, four different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and cocreate recommendations to improve access to medicines advice in community pharmacies. Three recommendations were developed and centred on: (i) delivering and providing culturally competent medicines advice; (ii) building awareness of accessing medicines advice from community pharmacies; and (iii) enabling better discussions with patients from ethnic minority communities.

CONCLUSIONS

These recommendations have the potential to support community pharmacy services to overcome ethnic inequalities affecting medicines advice; service commissioners should consider these findings to best meet the needs of ethnic minority patients. Cultural competence training for community pharmacy staff could support the creation of pharmacies as inclusive healthcare settings. Collaborative working with ethnic minority communities could enable specific tailoring of medicines-centred services to best meet their needs.

PATIENT OR PUBLIC CONTRIBUTION

The National Institute for Health Research (NIHR) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualization. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and findings were reported, with cultural competence.

TRIAL REGISTRATION

Not applicable.

The effect of the Original MethOd at pharmacy To ENhAnce Support for Health Improvement in the limited Japanese proficiency patients visiting local community pharmacy: A randomized controlled trial

OBJECTIVES

With an increase in globalization, the number of non-native-speaking citizens and tourists visiting local pharmacies is rapidly growing worldwide, creating linguistic and sociological problems. The aim of this study is to compare the effect of adding our original method, Original MethOd at pharmacy To ENhAnce Support for Health Improvement (OMOTENASHI), to the conventional medication counselling method (CMC) when counselling non-Japanese patients at the pharmacy.

METHODS

The OMOTENASHI consists of tools written in multiple languages and illustrations to clarify the effects and side effects, and to confirm patients' understanding. 71 non-Japanese patients were recruited and randomly assigned to the OMOTENASHI or to the CMC in a 1:1 ratio. Comprehension and satisfaction level were evaluated.

RESULTS

The overall comprehension level was significantly higher in the OMOTENASHI than in the CMC (75% vs 38%, p = 0.002), with a prominent difference in the recognition of the name, effects, side effects, precautions, and how to deal with side effects of the prescribed medication.

CONCLUSION

The OMOTENASHI to be a helpful tool in providing essential information to non-native-speaking patients.

PRACTICE IMPLICATION

The study highlighted the need to ensure every patient's safety and interests, and to avoid disadvantages caused by limited language proficiency in the globalization era.