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Bizuayehu HM, Belachew SA, Jahan S, Diaz A, Baxi S, Griffiths K, Garvey G. Utilisation of endocrine therapy for cancer in Indigenous peoples: a systematic review and meta-analysis. BMC Cancer 2024; 24:882. [PMID: 39039483 DOI: 10.1186/s12885-024-12627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Indigenous peoples worldwide experience inequitable cancer outcomes, and it is unclear if this is underpinned by differences in or inadequate use of endocrine treatment (ET), often used in conjunction with other cancer treatments. Previous studies examining ET use in Indigenous peoples have predominately focused on the sub-national level, often resulting in small sample sizes with limited statistical power. This systematic review aimed to collate the findings ofarticles on ET utilisation for Indigenous cancer patients and describe relevant factors that may influence ET use. METHODS We conducted a systematic review and meta-analysis of studies reporting ET use for cancer among Indigenous populations worldwide. PubMed, Scopus, CINAHL, Web of Science, and Embase were searched for relevant articles. A random-effect meta-analysis was used to pool proportions of ET use. We also performed a subgroup analysis (such as with sample sizes) and a meta-regression to explore the potential sources of heterogeneity. A socio-ecological model was used to present relevant factors that could impact ET use. RESULTS Thirteen articles reported ET utilisation among Indigenous populations, yielding a pooled estimate of 67% (95% CI:54 - 80), which is comparable to that of Indigenous populations 67% (95% CI: 53 - 81). However, among studies with sufficiently sized study sample/cohorts (≥ 500), Indigenous populations had a 14% (62%; 95% CI:43 - 82) lower ET utilisation than non-Indigenous populations (76%; 95% CI: 60 - 92). The ET rate in Indigenous peoples of the USA (e.g., American Indian) and New Zealand (e.g., Māori) was 72% (95% CI:56-88) and 60% (95% CI:49-71), respectively. Compared to non-Indigenous populations, a higher proportion of Indigenous populations were diagnosed with advanced cancer, at younger age, had limited access to health services, lower socio-economic status, and a higher prevalence of comorbidities. CONCLUSIONS Indigenous cancer patients have lower ET utilisation than non-Indigenous cancer patients, despite the higher rate of advanced cancer at diagnosis. While reasons for these disparities are unclear, they are likely reflecting, at least to some degree, inequitable access to cancer treatment services. Strengthening the provision of and access to culturally appropriate cancer care and treatment services may enhance ET utilisation in Indigenous population. This study protocol was registered on Prospero (CRD42023403562).
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Affiliation(s)
- Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Sewunet Admasu Belachew
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Shafkat Jahan
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Abbey Diaz
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Siddhartha Baxi
- GenesisCare Australia, Griffith University, Gold Coast, Australia
| | - Kalinda Griffiths
- Poche SA+NT, Flinders University, Darwin, Australia
- Menzies School of Health Research, Darwin, Australia
- Centre for Big Data Research in Health, UNSW, Sydney, Australia
| | - Gail Garvey
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
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Kerr M, Jaure A, Stephens JH, Kim S, Cutler R, Cashmore B, Dickson M, Evangelidis N, Hughes JT, Roberts I, Scholes-Robertson N, Sinka V, Craig JC. Experiences of Indigenous Patients Receiving Dialysis: Systematic Review of Qualitative Studies. Am J Kidney Dis 2024; 83:139-150.e1. [PMID: 37730171 DOI: 10.1053/j.ajkd.2023.07.014] [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: 04/03/2023] [Revised: 06/30/2023] [Accepted: 07/09/2023] [Indexed: 09/22/2023]
Abstract
RATIONALE & OBJECTIVE Indigenous People suffer a high burden of kidney disease. Those receiving maintenance dialysis have worse outcomes compared with similarly treated non-Indigenous patients. We characterized the experiences of Indigenous patients receiving dialysis in British-colonized countries to gain insights into which aspects of kidney care may benefit from improvement. STUDY DESIGN A systematic review of published qualitative interview studies. SETTING & STUDY POPULATIONS Indigenous Peoples aged 18 years and over, receiving hemodialysis or peritoneal dialysis in British-colonized countries. SELECTION CRITERIA FOR STUDIES Search terms for Indigenous Peoples, dialysis, and qualitative research were entered into Medline, Embase, PsycINFO, and CINAHL and searched from inception to January 5, 2023. DATA EXTRACTION Characteristics of each study were extracted into Microsoft Excel for quality assessment. ANALYTICAL APPROACH Data were analyzed using thematic synthesis. RESULTS The analysis included 28 studies involving 471 participants from Australia, New Zealand, Canada, and the United States. We identified four themes: centrality of family and culture (continuing dialysis for family, gaining autonomy through shared involvement, balancing primary responsibility to care for family); marginalization due to structural and social inequities (falling through gaps in primary care intensifying shock, discriminated against and judged by specialists, alienated and fearful of hospitals, overwhelmed by travel, financial and regimental burdens); vulnerability in accessing health care (need for culturally responsive care, lack of language interpreters, without agency in decision-making, comorbidities compounding complexity of self-management); and distress from separation from community (disenfranchisement and sorrow when away for dialysis, inability to perpetuate cultural continuity, seeking a kidney transplant). LIMITATIONS We only included articles published in English. CONCLUSIONS Indigenous patients receiving dialysis experience inequities in health care that compound existing accessibility issues caused by colonization. Improving the accessibility and cultural responsiveness of dialysis and kidney transplant services in collaboration with Indigenous stakeholders holds promise to enhance the experience of Indigenous patients receiving dialysis. PLAIN-LANGUAGE SUMMARY Worldwide Indigenous populations suffer a high incidence of chronic disease leading to lower life expectancy, particularly for kidney disease, an insidious condition requiring long-term dialysis treatment. By listening to Indigenous dialysis patients' stories, we hoped to understand how to improve their experience. We gathered 28 qualitative research studies from four countries reporting Indigenous adults' experiences of dialysis. They described lacking awareness of kidney disease, poor access to health services, systemic racism, inadequate cultural safety, and being dislocated from family, community, and culture. These findings indicate that respectful collaboration with Indigenous Peoples to craft and implement policy changes holds promise to improve prevention, integrate culturally responsive health care practices, and provide better access to local dialysis services and opportunities for kidney transplants.
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Affiliation(s)
- Marianne Kerr
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Allison Jaure
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jacqueline H Stephens
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Richard Cutler
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Brydee Cashmore
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Michelle Dickson
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nicole Evangelidis
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jaquelyne T Hughes
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Adelaide, Australia
| | - Ieyesha Roberts
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Victoria Sinka
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Collins JC, Hu J, McMillan SS, O'Reilly CL, El-Den S, Kelly F, Spinks J, Riley T, Wheeler AJ. Medication-related problems identified by community pharmacists: a descriptive case study of two Australian populations. J Pharm Policy Pract 2023; 16:133. [PMID: 37919809 PMCID: PMC10621197 DOI: 10.1186/s40545-023-00637-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Medication-related problems (MRPs) contribute significantly to preventable patient harm and global healthcare expenditure. Vulnerable populations, including Indigenous Australians (please note that the use of the term 'Indigenous' in this paper includes all Aboriginal and Torres Strait Islander people and acknowledges their rich traditions and heterogenous cultures.) and people living with severe and persistent mental illness (SPMI), may be at increased risk of MRPs. Pharmacist-led medication reviews can identify MRPs for targeted action. OBJECTIVE To characterize MRPs identified and recommendations made by community pharmacists during medication reviews conducted with Indigenous Australians and people living with SPMI. METHODS Participants were recruited through two Australian trials testing the feasibility and/or effectiveness of novel community pharmacist-led interventions, the Indigenous Medication Review Service (IMeRSe) feasibility study (June 2018-July 2019) and Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (September 2020-December 2021). Trained community pharmacists conducted medication reviews responsive to the cultural and health needs of participants. MRPs, MRP severity and pharmacist recommendations were documented and classified using an established classification system (DOCUMENT). MRP severity was assessed by pharmacists and an independent assessor. Data were analysed descriptively, and paired t-tests were used to compare severity ratings. RESULTS Pharmacists identified 795 MRPs with 411 participants across both trials (n = 255 IMeRSe, n = 156 PharMIbridge). Non-adherence to medication was the most common (n = 157, 25.1%) and second-most common (n = 25, 14.7%) MRP in IMeRSe and PharMIbridge, respectively. Undertreatment was the second-most common MRP in the sample of Indigenous Australians (n = 139, 22.2%), and reports of toxicity/adverse reactions were most common in people living with SPMI (n = 41, 24.1%). A change in pharmacotherapy was the most frequent recommendation made by pharmacists (40.2% and 55.0% in IMeRSe and PharMIbridge, respectively). Severity ratings varied, with the majority being 'Mild' or 'Moderate' in both groups. Significant differences were found in the severity rating assigned by trial pharmacists and the independent assessor. CONCLUSIONS Community pharmacists identified a range of MRPs experienced by two at-risk populations, most commonly non-adherence and toxicity or adverse reactions, when conducting medication reviews and proposed diverse strategies to manage these, frequently recommending a change in pharmacotherapy. These findings highlight the opportunity for more targeted approaches to identifying and managing MRPs in primary care and tailored community pharmacist-led interventions may be of value in this space. TRAIL REGISTRATION Australian and New Zealand Clinical Trial Registry records (IMeRSe ACTRN12618000188235 registered 06/02/2018 & PharMIbridge ACTRN12620000577910 registered 18/05/2020).
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Affiliation(s)
- Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Fiona Kelly
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Jean Spinks
- Centre for Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
| | - Toni Riley
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia.
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia.
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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Fazelipour M, Leung L, Min J, Ryan TS. Building practice-informed indigenous health curricula: A systematic review of pharmacy services for indigenous peoples. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1448-1460. [PMID: 36180334 DOI: 10.1016/j.cptl.2022.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/05/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND An increased need is recognized to improve Indigenous cultural safety curriculum. This review aimed to inform curriculum development by identifying and categorizing challenges and opportunities that underlie existing practices. This entails policies, pharmacy services, and health workers' perspectives associated with pharmacy services for Indigenous peoples of Australia, Canada, New Zealand, and the United States. METHODS Four academic databases were screened including PubMed, Embase, CINAHL, and Web of Science. This search was complemented by grey literature database searches. Thematic analysis by NVivo, version 12 (QSR International) was utilized to analyze qualitative data, and a narrative strategy guided common theme consolidation. This approach was prefaced and supplemented using Endnote X9 (Clarivate) and SUMARI 2019 (JBI) and according to the Joanna Briggs Institute's guidelines. An Indigenous Curriculum Advisory Committee at the University of British Columbia Pharmaceutical Sciences was queried for suggestions, potential cross-cultural interpretation, and guidance for explicit content in the context of pharmacy service delivery in Indigenous communities. RESULTS Fourteen studies were included and classified into three categories: (1) Indigenous patients', pharmacists', and health care providers' perspectives, (2) policies and practices, (3) pharmacy-based programs. Thematic analysis portrayed several themes with overlapping presentation of challenges and opportunities. It is important to utilize evidence-based strategies for improving the effectiveness of culturally-safe pharmacy services for Indigenous populations and for optimizing education and practice-informed curriculum development. IMPLICATIONS This information can inform pharmacists, educators, and faculty members in understanding and delivering optimal care and education engaging Indigenous insights and perspectives at systems and curricular levels.
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Affiliation(s)
- Mojan Fazelipour
- University of British Columbia, Faculty of Pharmaceutical Sciences, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Larry Leung
- University of British Columbia, Faculty of Pharmaceutical Sciences, 3515 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Jason Min
- Pharmaceutical Sciences, UBC School of Nursing, Faculty of Applied Science, 6524 Pharmaceutical Sciences Building, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Teresa Sm'hayetsk Ryan
- Forest and Conservation Sciences, UBC Forestry, 3035 - 2424 Main Mall, Vancouver, BC V6T 1Z4, Canada.
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Walke E, Barclay L, Longman J. Scoping review - What do we know about Aboriginal peoples' use of dose administration aids? Health Promot J Austr 2022; 33 Suppl 1:117-127. [PMID: 35122366 PMCID: PMC9790548 DOI: 10.1002/hpja.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED This paper aims to report findings of a scoping review which mapped and summarised available literature regarding Aboriginal peoples' use of Dose Administration Aids (DAAs) for improved medication management. Aboriginal and Torres Strait Islander peoples have higher rates of chronic disease than other Australians. This leads to increased numbers of prescribed medications and complex medication taking regimens. The Australian Government and Pharmacy Bodies provide programs for Aboriginal peoples with chronic conditions, including programs supporting access to DAAs to improve medication adherence. METHODS The search strings used included three key concepts: Indigeneity; DAAs and outcomes. PubMed, Medline via Ovid and the grey literature were searched. RESULTS After removal of duplicates, 426 papers were screened by title and abstract for inclusion. A further 407 papers were then excluded leaving a total of nineteen papers included in the review. Only three of these papers included all three concepts in the search criteria, and none of these were empirical studies. CONCLUSION The lack of studies found in this review support the requirement for empirical research regarding the effects of DAAs on medication taking behaviours of Aboriginal people, and the programs that provide them. SO WHAT?: The Australian Government funds programs that provides access to DAAs as a method of improving medication taking behaviours. But what do we really know about DAAs and if or how they assist in this goal? This review scopes out what is known, in order to direct studies that will answer this question.
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Affiliation(s)
- Emma Walke
- Academic Lead – Aboriginal HealthUniversity Centre for Rural Health North CoastUniversity of SydneyLismoreNew South WalesAustralia
| | | | - Jo Longman
- University Centre for Rural Health North CoastUniversity of SydneyLismoreNew South WalesAustralia
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Drovandi A, Smith D, Preston R, Morris L, Page P, Swain L, Biros E, Tremlett M, Loller H, Stephens M, Nugent A, Vaughan F, Couzos S. Enablers and barriers to non-dispensing pharmacist integration into the primary health care teams of Aboriginal community-controlled health services. Res Social Adm Pharm 2022; 18:3766-3774. [PMID: 35581127 DOI: 10.1016/j.sapharm.2022.05.002] [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: 01/12/2022] [Revised: 04/08/2022] [Accepted: 05/01/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The primary health care management of chronic disease affecting Aboriginal and Torres Strait Islander peoples requires healthcare quality and equity demands to be met, and systems that foster better team-based care. Non-dispensing pharmacists (NDPs) integrated within primary healthcare settings can enhance the quality of patient care, although factors that enable or challenge integration within these settings need to be better understood. OBJECTIVES To investigate enabling factors and barriers influencing integration of NDPs within Aboriginal community-controlled health services delivering primary health care. This was achieved through qualitative evaluation of the Integrating Pharmacists within Aboriginal Community Controlled Health Services (IPAC) Trial exploring the perceptions of NDPs, community pharmacists, healthcare staff, managers, and Aboriginal and Torres Strait Islander patients of these services. METHODS NDPs were employed across twenty urban, rural, and remote services in three Australian states and provided pre-defined medication-related roles to adult Aboriginal and Torres Strait Islander patients. Perceptions were elicited from online surveys, interviews, and focus groups. Transcripts were thematically analyzed using the constant comparison method to identify, compare, and refine emerging themes. RESULTS One hundred and four participants informed the findings, including 24 NDPs, 13 general practitioners, 12 service managers, 10 community pharmacists, 17 health service staff, and 17 patients. Enablers of integration included: personal (previous experience with Aboriginal and Torres Strait Islander peoples, cultural awareness, skills, individual attributes); health service-related (induction programs, Aboriginal Health Worker support, team-building initiatives); and community-related factors (engaged community elders, leaders, cultural mentors, community pharmacy champions). Barriers to NDP integration included a lack of systems supports for patients and staff to adapt to NDP roles, health service factors, travel requirements, a lack of community linkages, and time and budget constraints. CONCLUSIONS NDP integration within primary health care services has potential to enhance medication-related services to Aboriginal and Torres Strait Islander peoples if enabling factors are supported and health systems and adequate resources facilitate the integration of pharmacists within these settings.
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Affiliation(s)
- Aaron Drovandi
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Deborah Smith
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Robyn Preston
- College of Medicine and Dentistry, James Cook University, Townsville, Australia; School of Health, Medical and Applied Sciences, Central Queensland University, Townsville, Australia
| | - Lucy Morris
- Queensland Aboriginal and Islander Health Council, Cairns, Queensland, Australia
| | - Priscilla Page
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Lindy Swain
- Kimberley Rural Health Alliance, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Erik Biros
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Megan Tremlett
- Pharmaceutical Society of Australia, Canberra, Australian Capital Territory, Australia
| | - Hannah Loller
- Pharmaceutical Society of Australia, Canberra, Australian Capital Territory, Australia
| | - Mike Stephens
- National Aboriginal Community Controlled Health Organisation, Canberra, Australian Capital Territory, Australia
| | - Alice Nugent
- National Aboriginal Community Controlled Health Organisation, Canberra, Australian Capital Territory, Australia
| | - Fran Vaughan
- National Aboriginal Community Controlled Health Organisation, Canberra, Australian Capital Territory, Australia
| | - Sophia Couzos
- College of Medicine and Dentistry, James Cook University, Townsville, Australia.
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Māori, pharmacists, and medicines adherence – A mixed methods study exploring indigenous experiences of taking medicines ‘as prescribed’ and mechanisms of support. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 7:100175. [PMID: 36106156 PMCID: PMC9465430 DOI: 10.1016/j.rcsop.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/03/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Objectives Methods Results Conclusions Māori experiences of medicines adherence are diverse. Pharmacists can support Māori medicines adherence in a variety of practical ways. Indigenous-led research promotes discourse reflective of Indigenous experience.
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Murfet G, Ostaszkiewicz J, Rasmussen B. Diabetes Capabilities for the Healthcare Workforce Identified via a 3-Staged Modified Delphi Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1012. [PMID: 35055832 PMCID: PMC8775604 DOI: 10.3390/ijerph19021012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 11/29/2022]
Abstract
Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages lead to consumer disengagement. The study aimed to identify capabilities required by health professionals to deliver diabetes education and care to develop a national consensus capability-based framework to guide their training. A 3-staged modified Delphi technique was used to gain agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage I) a semi-structured consultation group and pre-Delphi pilot, (Stage II) a 2-phased online Delphi survey, and (Stage III) a semi-structured focus group and appraisal by health professional regulatory and training organisations. Descriptive statistics and central tendency measures calculated determined quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Eighty-four diabetes experts were recruited from nursing and midwifery (n = 60 [71%]), allied health (n = 17 [20%]), and pharmacy (n = 7 [9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care, and 2 to 16 statements attained consensus for each capability-259 in total. Additionally, workforce solutions were identified to expand capacity for diabetes care. The rigorous consultation process led to the design and validation of a Capability Framework for Diabetes Care that addresses workforce enablers identified by the Australian National Diabetes Strategy. It recognises diversity, creating shared understandings of diabetes across health professional disciplines. The findings will inform diabetes policy, practice, education, and research.
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Affiliation(s)
- Giuliana Murfet
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
- Diabetes Centre, Tasmanian Health Service, Burnie, TAS 7250, Australia
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Joan Ostaszkiewicz
- National Aging Research Institute, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
- Western Health Partnership, 176 Furlong Road, St Albans, VIC 3021, Australia
- Department of Public Health, University of Copenhagen, Nørregade 10, DK-1017 Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark
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9
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Keitaanpaa S, Cass A, Hefler M, Thomas DP. Using Pharmaceutical Benefit Scheme data to understand the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers. Aust N Z J Public Health 2021; 45:34-38. [PMID: 33522685 DOI: 10.1111/1753-6405.13031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/01/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine the supply of smoking cessation medicines to Aboriginal and Torres Strait Islander smokers compared to non-Indigenous smokers across Australia. METHODS We analysed the total number of smoking cessation prescriptions dispensed over three years through the Pharmaceutical Benefits Scheme (PBS) compared to those supplied nationally through the Closing the Gap (CTG) measure and also in the Northern Territory through the Remote Area Aboriginal Health Service (RAAHS) program. RESULTS Aboriginal and Torres Strait Islander smokers were supplied with fewer smoking cessation medicines per smoker under the CTG measure compared to non-Indigenous smokers under general PBS benefits. Supply of medicines though the RAAHS program complicated the use of CTG data where higher proportions of Aboriginal and Torres Strait Islander people live in remote areas and use of the CTG measure is lower. CONCLUSIONS Fewer smoking cessation medicines are being prescribed and then dispensed to Aboriginal and Torres Strait Islander smokers than to non-Indigenous smokers. Implications for public health: CTG and RAAHS data may be useful to monitor and evaluate the effectiveness of interventions to improve the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers. However, there are limitations and current obstacles to accessing RAAHS data would need to be removed.
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Affiliation(s)
- Samuel Keitaanpaa
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory
| | - David P Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory
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Couzos S, Smith D, Stephens M, Preston R, Hendrie D, Loller H, Tremlett M, Nugent A, Vaughan F, Crowther S, Boyle D, Buettner P, Biros E. Integrating pharmacists into Aboriginal Community Controlled Health Services (IPAC project): Protocol for an interventional, non-randomised study to improve chronic disease outcomes. Res Social Adm Pharm 2020; 16:1431-1441. [DOI: 10.1016/j.sapharm.2019.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/17/2019] [Accepted: 12/24/2019] [Indexed: 10/25/2022]
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11
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Welch S, McMillan F, Moles R. Hospital pharmacy services supporting Aboriginal or Torres Strait Islander peoples in Australia: a systematic review. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2020. [DOI: 10.1002/jppr.1666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Susan Welch
- Senior Pharmacist St. Vincent's Hospital Sydney Australia
- Clinical Associate Lecturer Sydney Pharmacy School The Faculty of Medicine and Health University of Sydney CamperdownSydney Australia
| | - Faye McMillan
- School of Nursing, Midwifery and Indigenous Health Charles Sturt University Wagga Wagga Australia
| | - Rebekah Moles
- Sydney Pharmacy School The Faculty of Medicine and Health University of Sydney Camperdown Sydney Australia
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12
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Nguyen MT, Gallagher C, Pitman BM, Emami M, Kadhim K, Hendriks JM, Middeldorp ME, Roberts-Thomson KC, Mahajan R, Lau DH, Sanders P, Wong CX. Quality of Warfarin Anticoagulation in Indigenous and Non-Indigenous Australians With Atrial Fibrillation. Heart Lung Circ 2020; 29:1122-1128. [PMID: 31980393 DOI: 10.1016/j.hlc.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/20/2019] [Accepted: 11/10/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies have shown that suboptimal anticoagulation quality, as measured by time in therapeutic range (TTR), affects a significant percentage of patients with atrial fibrillation (AF). However, TTR has not been previously characterised in Indigenous Australians who experience a greater burden of AF and stroke. METHOD Indigenous and non-Indigenous Australians with AF on warfarin anticoagulation therapy were identified from a large tertiary referral centre between 1999 and 2012. Time in therapeutic range was calculated as a proportion of daily international normalised ratio (INR) values between 2 and 3 for non-valvular AF and 2.5 to 3.5 for valvular AF. INR values between tests were imputed using the Rosendaal technique. Linear regression models were employed to characterise predictors of TTR. RESULTS Five hundred and twelve (512) patients with AF on warfarin were included (88 Indigenous and 424 non-Indigenous). Despite younger age (51±13 vs 71±12 years, p<0.001), Indigenous Australians had greater valvular heart disease, diabetes, and alcohol excess compared to non-Indigenous Australians (p<0.05 for all). Time in therapeutic range was significantly lower in Indigenous compared to non-Indigenous Australians (40±29 vs 50±31%, p=0.006). Univariate predictors of poorer TTR included Indigenous ethnicity, younger age, diuretic use, and comorbidities, such as valvular heart disease, heart failure and chronic obstructive pulmonary disease (p<0.05 for all). Valvular heart disease remained a significant predictor of poorer TTR in multivariate analyses (p=0.004). CONCLUSION Indigenous Australians experience particularly poor warfarin anticoagulation quality. Our data also suggest that many non-Indigenous Australians spend suboptimal time in therapeutic range. These findings reinforce the importance of monitoring warfarin anticoagulation quality to minimise stroke risk.
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Affiliation(s)
- Mau T Nguyen
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Celine Gallagher
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Bradley M Pitman
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Mehrdad Emami
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Kadhim Kadhim
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Jeroen M Hendriks
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Melissa E Middeldorp
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Kurt C Roberts-Thomson
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Rajiv Mahajan
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Dennis H Lau
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Prashanthan Sanders
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Christopher X Wong
- Centre for Heart Rhythm (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia.
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13
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de Dassel JL, de Klerk N, Carapetis JR, Ralph AP. How Many Doses Make a Difference? An Analysis of Secondary Prevention of Rheumatic Fever and Rheumatic Heart Disease. J Am Heart Assoc 2019; 7:e010223. [PMID: 30561268 PMCID: PMC6405600 DOI: 10.1161/jaha.118.010223] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Acute rheumatic fever ( ARF ) and rheumatic heart disease cause substantial burdens worldwide. Long-term antibiotic secondary prophylaxis is used to prevent disease progression, but evidence for benefits of different adherence levels is limited. Using data from northern Australia, we identified factors associated with adherence, and the association between adherence and ARF recurrence, progression to rheumatic heart disease, worsening or improvement of rheumatic heart disease, and mortality. Methods and Results Factors associated with adherence (percent of doses administered) were analyzed using logistic regression. Nested case-control and case-crossover designs were used to investigate associations with clinical outcomes; conditional logistic regression was used to estimate odds ratios ( OR ) with 95% CIs Adherence estimates (7728) were analyzed. Being female, younger, having more-severe disease, and living remotely were associated with higher adherence. Alcohol misuse was associated with lower adherence. The risk of ARF recurrence did not decrease until ≈40% of doses had been administered. Receiving <80% was associated with a 4-fold increase in the odds of ARF recurrence (case-control OR : 4.00 [95% CI : 1.7-9.29], case-crossover OR : 3.31 [95% CI : 1.09-10.07]) and appeared to be associated with increased all-cause mortality (case-control OR : 1.90 [95% CI : 0.89-4.06]; case-crossover OR 1.91 [95% CI : 0.51-7.12]). Conclusions We show for the first time that increased adherence to penicillin prophylaxis is associated with reduced ARF recurrence, and a likely reduction in mortality, in our setting. These findings can motivate patients to receive doses since even relatively low adherence can be beneficial, and additional doses further reduce adverse clinical outcomes.
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Affiliation(s)
| | - Nick de Klerk
- 3 Telethon Kids Institute University of Western Australia Perth Australia
| | - Jonathan Rhys Carapetis
- 3 Telethon Kids Institute University of Western Australia Perth Australia.,4 Princess Margaret Hospital for Children Perth Australia
| | - Anna P Ralph
- 1 Menzies School of Health Research Charles Darwin University Darwin Australia.,2 Royal Darwin Hospital Darwin Australia
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14
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Liaw JY, White AV, Gorton S, Axford-Haines L. Lessons to be learned: Using National Immunisation strategies to improve adherence to acute rheumatic fever secondary prophylaxis. J Paediatr Child Health 2019; 55:1170-1176. [PMID: 31410921 DOI: 10.1111/jpc.14596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022]
Abstract
Rheumatic heart disease, as a result of a single or recurrent episode of acute rheumatic fever (ARF), remains a significant cause of morbidity and mortality in northern and remote Australia; ARF has a peak incidence among 5-14-year-old Aboriginal and Torres Strait Islander children. Long-term regular benzathine penicillin G injections are the only currently successful secondary prevention strategy; however, rates of adherence remain critically low. In contrast, rates of adherence to immunisations on the National Immunisation Program (NIP) Schedule are high, even among this target population. This article compares strategies used to implement and improve ARF secondary prophylaxis with those used in the NIP. Some successful NIP strategies, such as Service Incentive Payment for health providers, home-visiting delivery models and integration into the National Immunisation Register, if applied to ARF secondary prophylaxis have the potential to improve benzathine penicillin G adherence.
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Affiliation(s)
- Joshua Y Liaw
- Discipline of Child and Adolescent Health, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Andrew V White
- Discipline of Child and Adolescent Health, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Department of Paediatrics, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Susan Gorton
- Discipline of Child and Adolescent Health, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Louise Axford-Haines
- Rheumatic Heart Disease Register and Control Program (Queensland) Public Health Unit, Townsville Hospital and Health Service, Townsville, Queensland, Australia
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15
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Page A, Hyde Z, Smith K, Etherton‐Beer C, Atkinson DN, Flicker L, Skeaf L, Malay R, LoGiudice DC. Potentially suboptimal prescribing of medicines for older Aboriginal Australians in remote areas. Med J Aust 2019; 211:119-125. [DOI: 10.5694/mja2.50226] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/25/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Amy Page
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
- Alfred Health Melbourne VIC
- Centre for Medicine Use and Safety Monash University Melbourne VIC
| | - Zoë Hyde
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
| | - Kate Smith
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
| | | | - David N Atkinson
- University of Western Australia Broome WA
- Broome Regional Aboriginal Medical Service Broome WA
| | - Leon Flicker
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
- Melbourne Health Melbourne VIC
| | - Linda Skeaf
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
| | - Roslyn Malay
- Western Australian Centre for Health and Ageing University of Western Australia Perth WA
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Goldberg LR, Cox T, Hoang H, Baldock D. Addressing dementia with Indigenous peoples: a contributing initiative from the Circular Head Aboriginal community. Aust N Z J Public Health 2018; 42:424-426. [DOI: 10.1111/1753-6405.12798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | - Ha Hoang
- Centre for Rural HealthUniversity of Tasmania
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