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McCann J, Lau WM, Husband A, Todd A, Sile L, Doll AK, Varia S, Robinson‐Barella A. 'Creating a culturally competent pharmacy profession': A qualitative exploration of pharmacy staff perspectives of cultural competence and its training in community pharmacy settings. Health Expect 2023; 26:1941-1953. [PMID: 37357812 PMCID: PMC10485312 DOI: 10.1111/hex.13803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/15/2023] [Accepted: 06/12/2023] [Indexed: 06/27/2023] Open
Abstract
INTRODUCTION Cultural competence is an important attribute underpinning interactions between healthcare professionals, such as pharmacists, and patients from ethnic minority communities. Health- and medicines-related inequalities affecting people from underrepresented ethnic groups, such as poorer access to healthcare services and poorer overall treatment outcomes in comparison to their White counterparts, have been widely discussed in the literature. Community pharmacies are the first port of call for healthcare services accessed by diverse patient populations; yet, limited research exists which explores the perceptions of culturally competent care within the profession, or the delivery of cultural competence training to community pharmacy staff. This research seeks to gather perspectives of community pharmacy teams relating to cultural competence and identify possible approaches for the adoption of cultural competence training. METHODS Semistructured interviews were conducted in-person, over the telephone or via video call, between October and December 2022. Perspectives on cultural competence and training were discussed. Interviews were audio-recorded and transcribed verbatim. The reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Newcastle University Ethics Committee (reference: 25680/2022). RESULTS Fourteen participants working in community pharmacies were interviewed, including eight qualified pharmacists, one foundation trainee pharmacist, three pharmacy technicians/dispensers and two counter assistants. Three themes were developed from the data which centred on (1) defining and appreciating cultural competency within pharmacy services; (2) identifying pharmacies as 'cultural hubs' for members of the diverse, local community and (3) delivering cultural competence training for the pharmacy profession. CONCLUSION The results of this study offer new insights and suggestions on the delivery of cultural competence training to community pharmacy staff, students and trainees entering the profession. Collaborative co-design approaches between patients and pharmacy staff could enable improved design, implementation and delivery of culturally competent pharmacy services. PATIENT OR PUBLIC CONTRIBUTION The Patient and Public Involvement and Engagement group at Newcastle University had input in the study design and conceptualisation. Two patient champions inputted to ensure that the study was conducted, and the findings were reported, with cultural sensitivity.
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Affiliation(s)
- Jessica McCann
- School of PharmacyNewcastle UniversityNewcastle upon TyneUK
| | - Wing Man Lau
- School of PharmacyNewcastle UniversityNewcastle upon TyneUK
| | - Andy Husband
- School of PharmacyNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Adam Todd
- School of PharmacyNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Laura Sile
- Alumni, School of PharmacyLiverpool John Moore UniversityLiverpoolUK
| | | | - Sneha Varia
- Centre for Pharmacy Postgraduate Education, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Anna Robinson‐Barella
- School of PharmacyNewcastle UniversityNewcastle upon TyneUK
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
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Biggs MA, Serrano S, Valladares ES, Grossman D. Development of a Spanish-language drug facts label prototype for a combination mifepristone and misoprostol medication abortion product. Contraception 2023; 118:109906. [PMID: 36309228 DOI: 10.1016/j.contraception.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 01/11/2023]
Abstract
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.
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Affiliation(s)
- M Antonia Biggs
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, United States.
| | - Sabrina Serrano
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, United States
| | | | - Daniel Grossman
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, United States
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Robinson A, Sile L, Govind T, Guraya HK, O'Brien N, Harris V, Pilkington G, Todd A, Husband A. 'He or she maybe doesn't know there is such a thing as a review': A qualitative investigation exploring barriers and facilitators to accessing medication reviews from the perspective of people from ethnic minority communities. Health Expect 2022; 25:1432-1443. [PMID: 35384182 PMCID: PMC9327850 DOI: 10.1111/hex.13482] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Regular reviews of medications, including prescription reviews and adherence reviews, are vital to support pharmacological effectiveness and optimize health outcomes for patients. Despite being more likely to report a long‐term illness that requires medication when compared to their white counterparts, individuals from ethnic minority communities are less likely to engage with regular medication reviews, with inequalities negatively affecting their access. It is important to understand what barriers may exist that impact the access of those from ethnic minority communities and to identify measures that may act to facilitate improved service accessibility for these groups. Methods Semi‐structured interviews were conducted between June and August 2021 using the following formats as permitted by governmental COVID‐19 restrictions: in person, over the telephone or via video call. Perspectives on service accessibility and any associated barriers and facilitators were discussed. Interviews were audio‐recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Health Research Authority (ref: 21/HRA/1426). Results In total 20 participants from ethnic minority communities were interviewed; these participants included 16 UK citizens, 2 refugees and 2 asylum seekers, and represented a total of 5 different ethnic groups. Three themes were developed from the data regarding the perceived barriers and facilitators affecting access to medication reviews and identified approaches to improve the accessibility of such services for ethnic minority patients. These centred on (1) building knowledge and understanding about medication reviews; (2) delivering medication review services; and (3) appreciating the lived experience of patients. Conclusion The results of this study have important implications for addressing inequalities that affect ethnic minority communities. Involving patients and practitioners to work collaboratively in coproduction approaches could enable better design, implementation and delivery of accessible medication review services that are culturally competent. Patient or Public Contribution The National Institute for Health Research Applied Research Collaboration and Patient and Public Involvement and Engagement group at Newcastle University supported the study design and conceptualization. Seven patient champions inputted to ensure that the research was conducted, and the findings were reported, with cultural sensitivity.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Sile
- School of Pharmacy, Faculty of Medical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | | | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Suzuki S, Kato ET, Sato K, Konda M, Kuwabara Y, Yasuno S, Liu J, Masuda I, Ueshima K. 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. PATIENT EDUCATION AND COUNSELING 2022; 105:366-374. [PMID: 34059363 DOI: 10.1016/j.pec.2021.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Shota Suzuki
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan; Institute for Clinical and Translational Science, Nara Medical University Hospital, Nara, Japan.
| | - Eri Toda Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiko Sato
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Manako Konda
- Department of Preventive Services, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yoshihiro Kuwabara
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Yasuno
- Clinical Research Support Center, The Jikei University School of Medicine, Tokyo, Japan
| | - Jinliang Liu
- Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Izuru Masuda
- Medical Examination Center, Takeda Hospital, Kyoto, Japan
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
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Robinson A, Elarbi M, Todd A, Husband A. A qualitative exploration of the barriers and facilitators affecting ethnic minority patient groups when accessing medicine review services: Perspectives of healthcare professionals. Health Expect 2021; 25:628-638. [PMID: 34951087 PMCID: PMC8957739 DOI: 10.1111/hex.13410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/29/2021] [Accepted: 12/07/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Healthcare inequalities and ethnicity are closely related. Evidence has demonstrated that patients from ethnic minority groups are more likely to report a long‐term illness than their white counterparts; yet, in some cases, minority groups have reported poorer adherence to prescribed medicines and may be less likely to access medicine services. Knowledge of the barriers and facilitators that impact ethnic minority access to medicine services is required to ensure that services are fit for purpose to meet and support the needs of all. Methods Semistructured interviews with healthcare professionals were conducted between October and December 2020, using telephone and video call‐based software. Perspectives on barriers and facilitators were discussed. Interviews were audio‐recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Newcastle University Faculty of Medical Sciences Ethics Committee. Results Eighteen healthcare professionals were interviewed across primary, secondary and tertiary care settings; their roles spanned medicine, pharmacy and dentistry. Three themes were developed from the data regarding the perceived barriers and facilitators affecting access to medicine services for ethnic minority patients. These centred around patient expectations of health services; appreciating cultural stigma and acceptance of certain health conditions; and individually addressing communication and language needs. Conclusion This study provides much‐needed evidence relating to the barriers and facilitators impacting minority ethnic communities when seeking medicine support. The results of this study have important implications for the delivery of person‐centred care. Involving patients and practitioners in coproduction approaches could enable the design and delivery of culturally sensitive and accessible medicine services. Patient or Public Contribution The Patient and Public Involvement and Engagement (PPIE) group at Newcastle University had extensive input in the design and concept of this study before the research was undertaken. Throughout the work, a patient champion (Harpreet Guraya) had input in the project by ensuring that the study was conducted, and the findings were reported, with cultural sensitivity.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK.,Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Muna Elarbi
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK.,Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK.,Institute of Population Health Sciences, Newcastle University, Newcastle Upon Tyne, UK
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Mohammad A, Saini B, Chaar BB. Pharmacists' experiences serving culturally and linguistically diverse patients in the Australian community pharmacy setting. Int J Clin Pharm 2021; 43:1563-1573. [PMID: 34076804 DOI: 10.1007/s11096-021-01284-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
Background There has been no in depth published study to date reporting on community pharmacists' current experiences and their future practice needs relating to providing culturally competent pharmaceutical care to Australian culturally and linguistically diverse patients with low English proficiency. Objective To explore community pharmacists' experiences serving culturally and linguistically diverse patients who have low English proficiency. Setting Community pharmacists in Australia. Method Focus group discussions with practising community pharmacists were conducted. Participants were recruited from metropolitan Sydney. Discussion centred around their current experiences and practice changes needed to enhance the provision of culturally competent pharmaceutical care. Thematic analysis using the constant comparison method within a grounded theory approach was performed on the data collected. Main outcome measure Participants' experiences in providing culturally competent care to culturally and linguistically diverse patients with low English proficiency. Results Thirty community pharmacists participated in six focus group discussions. Inadequate provision of culturally competent care was found to be primarily due to the issue of language incongruence between pharmacist and patient. Participants proposed various means with which such care may be provided to ensure patient safety. Conclusion Pharmacist participants expressed being inadequately equipped to provide culturally competent care in the community setting and identified potential means by which such care may be delivered. Addressing identified barriers that hinder community pharmacists' capacity to engage in culturally competent practice can potentially improve provision of pharmaceutical care to culturally and linguistically diverse patients with low English proficiency.
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Affiliation(s)
- Annim Mohammad
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Bandana Saini
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Betty Bouad Chaar
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Sletvold H, Nguyen T. Experiences and perceptions of foreign-language customers on medication information received in the pharmacy - a focus group study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:330-335. [PMID: 33963846 DOI: 10.1093/ijpp/riab021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND In pharmacies, communication is essential for providing information about medicine and counselling customers on the correct use of medications. Previous studies have described pharmacists experiencing language and cultural barriers in communication with foreign-language (FL) customers. OBJECTIVE This study aimed to explore FL customer experiences and perceptions of medication information received in the pharmacy. METHODS A qualitative method was used, including interviews in five focus groups. Study participants (N = 18) spoke Arabic or Kurdish but lived in Norway and had the experience of purchasing medicine over the counter and/or prescription medicines in a Norwegian pharmacy. A descriptive thematic content analysis was conducted. KEY FINDINGS Overall, the FL customers were satisfied with the pharmacy service. However, they were divided in their views of the pharmacy role, which could affect how they received medication information. Communication barriers were prominent, and FL customers related language and cultural barriers to negative health outcomes. Their preferences on medication information were not met. Several communication facilitators that could support medication information were mentioned: simplified prescription labels, written information, pictograms, mobile apps, interpretators and bilingual staff. CONCLUSIONS The FL pharmacy customers' experience of communication barriers and unfulfilled needs for medical information can be a threat to patient safety. To overcome the barriers and ensure the correct use of medicines, health-care personnel in pharmacies must apply an array of communication aids, adapted to the diversity in language, culture and health literacy in the heterogenous population.
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Affiliation(s)
- Hege Sletvold
- Faculty of Nursing and Health Sciences, Nord University, Stjordal, Norway
| | - Thianna Nguyen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Smith MCJ, Yin HS, Sanders LM. Lost in translation: Medication labeling for immigrant families. J Am Pharm Assoc (2003) 2016; 56:677-679. [PMID: 27836127 DOI: 10.1016/j.japh.2016.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 06/20/2016] [Accepted: 07/03/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To identify the patient-safety hazards of current medication labeling standards for immigrant and language-minority families. SUMMARY The Latino population in the United States has increased by more than 40% over the past decade and the total child population born to Latino parents will surpass one-half of the population in many states. With recent health care and immigration policies, this demographic shift has a disproportional effect on the Latino families. Research shows that recent Latin American immigrants face disparities when encountering the U.S. pharmacy system. A review of these disparities shows how new policies should be informed when considering new pharmacy regulations to better address the cultural needs of recent Latin American families to improve medication understanding and adherence. CONCLUSION To date, research and regulatory requirements for medication safety in the United States have attended insufficiently to the patient-safety risk inherent in providing complex English-language labels to non-English-speaking families, many of whom have limited literacy in their native language. As families move, this patient-safety risk is increased by shifts in pharmacies, which often have different medication-labeling standards. It is important to examine how recent immigrant parents are addressing the medication needs for their children based on their cultural norms and how those cultural practices and acculturation into the U.S. health care system may affect their risk for injury. New research and policy efforts may help to address these barriers to safe medication use.
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Ratanawongsa N, Karter AJ, Quan J, Parker MM, Handley M, Sarkar U, Schmittdiel JA, Schillinger D. Reach and Validity of an Objective Medication Adherence Measure Among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study. J Manag Care Spec Pharm 2015; 21:688-98. [PMID: 26233541 PMCID: PMC4553246 DOI: 10.18553/jmcp.2015.21.8.688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using pharmacy claims could advance clinical care and translational research for safety net care. However, safety net patients may experience fluctuating prescription drug coverage, affecting the performance of adherence measures. OBJECTIVE To evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. METHODS We conducted this cross-sectional analysis using administrative and clinical data for 680 members eligible for a self-management support trial at a nonprofit, government-sponsored managed care plan. We applied CMG methodology to cardiometabolic medication claims for English- , Cantonese- , or Spanish-speaking members with diabetes. We examined inclusiveness (the proportion with calculable CMG) and selectivity (sociodemographic and medical differences from members without CMG). For validity, we examined unadjusted associations of suboptimal adherence (CMG > 20%) with suboptimal cardiometabolic control. RESULTS 429 members (63%) had calculable CMG. Compared with members without CMG, members with CMG were younger, more likely employed, and had poorer glycemic control but had better blood pressure and lipid control. Suboptimal adherence occurred more frequently among members with poor cardiometabolic control than among members with optimal control (28% vs. 12%, P = 0.02). CONCLUSIONS CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations. CMG may provide a useful tool to measure adherence among increasingly diverse Medicaid populations, complemented by other strategies to reach those not captured by CMG.
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Affiliation(s)
- Neda Ratanawongsa
- UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, 1001 Potrero Ave., Box 1364, San Francisco CA 94110.
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Wenger LM, Rosenthal M, Sharpe JP, Waite N. Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities. Res Social Adm Pharm 2015; 12:175-217. [PMID: 26119111 DOI: 10.1016/j.sapharm.2015.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/22/2015] [Accepted: 05/23/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges. OBJECTIVES Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities. METHODS Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes. RESULTS Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge. CONCLUSIONS As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action.
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Affiliation(s)
- Lisa M Wenger
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada.
| | - Meagen Rosenthal
- School of Pharmacy, The University of Mississippi, P.O. Box 1848, University, MS 38677, USA
| | - Jane Pearson Sharpe
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
| | - Nancy Waite
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
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Romain SJ. Pharmaceutical health care and Inuit language communications in Nunavut, Canada. Int J Circumpolar Health 2013; 72:21409. [PMID: 23984309 PMCID: PMC3754794 DOI: 10.3402/ijch.v72i0.21409] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requiring that all public and private sector essential services offer verbal and written communication in Inuit languages (Inuktitut and Inuinnaqtun) by 2012. Methods While the legislation mandates compliance, policy implementation for pharmaceutical services is problematic. Not a single pharmacist in Nunavut is fluent in either of the Inuit languages. Pharmacists have indicated challenges in formally translating written documentation into Inuit languages based on concerns for patient safety. These challenges of negotiating the joint requirements of language legislation and patient safety have resulted in pharmacies using verbal on-site translation as a tenuous solution regardless of its many limitations. Results The complex issues of pharmaceutical health care and communication among the Inuit of Nunavut are best examined through multimethod research to encompass a wide range of perspectives. This methodology combines the richness of ethnographic data, the targeted depth of interviews with key informants and the breadth of cross-Canada policy and financial analyses. Conclusions The analysis of this information would provide valuable insights into the current relationships between health care providers, pharmacists and Inuit patients and suggest future directions for policy that will improve the efficacy of pharmaceuticals and health care spending for the Inuit in Canada.
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Affiliation(s)
- Sandra J Romain
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada.
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Sentell T, Braun KL, Davis J, Davis T. Colorectal cancer screening: low health literacy and limited English proficiency among Asians and Whites in California. JOURNAL OF HEALTH COMMUNICATION 2013; 18 Suppl 1:242-55. [PMID: 24093359 PMCID: PMC3815112 DOI: 10.1080/10810730.2013.825669] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The authors examined the relationship between low health literacy (LHL), limited English proficiency (LEP), and meeting current U.S. Preventive Service Task Force colorectal cancer (CRC) screening guidelines for Asians and Whites in California. For 1,478 Asian and 14,410 White respondents 50-75 years of age in the 2007 California Health Interview Survey, the authors examined meeting CRC screening guidelines using multivariable logistic models by LEP and LHL separately and in combination. Analyses were run with the full sample, then separately for Whites and Asians controlling for demographics and insurance. For those with LEP, patient-provider language concordance and CRC screening was examined. Overall, respondents with LEP and LHL were the least likely to meet CRC screening guidelines (36%) followed by LEP-only (45%), LHL-only (51%), and those with neither LHL nor LEP (59%), a hierarchy that remained significant in multivariable models. For Whites, LHL-only was associated with screening, whereas LEP-only and LEP and LHL were significant for Asians. Having a language concordant provider was not significantly associated with CRC screening among those with LEP. Health literacy is associated with CRC screening, but English proficiency is also critical to consider. Asians with both LEP and LHL appear particularly vulnerable to cancer screening disparities.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Kathryn L. Braun
- Office of Public Health Studies, University of Hawai'i, and the ‘Imi Hale Native Hawaiian Cancer Network, Honolulu, Hawai'i, USA
| | - James Davis
- Biostatistics Core, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA
| | - Terry Davis
- Section of General Medicine, School of Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
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