A qualitative exploration of the barriers and facilitators affecting ethnic minority patient groups when accessing medicine review services: Perspectives of healthcare professionals

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.

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

“…This study adds to the growing evidence base considering access to medicines‐specific advice for ethnic minority populations 2–4,22,29 . This codesign research provided a platform to share the voices of members from ethnic minority communities and generate person‐centred recommendations to improve access to seeking medicines advice from community pharmacies.…”

“…In doing so, this may enable greater insight into specific tailored approaches or mechanisms that best meet the needs of individual underserved populations. 29 Interpreter services were acknowledged as a possible mechanism to support improved access to seeking medicines advice; however, participants recognized the contrast in availability and prevalence of interpreter services in community pharmacies compared to other UK healthcare settings, like General Practice surgeries. This echoes findings from other high-income countries where community pharmacists have played a role in delivering medicines reviews for patients from ethnic minority communities, including in Australia, 46,55,56 the United States, 57,58 Japan, 59 New Zealand 60 and Denmark.…”

“…This study adds to the growing evidence base considering access to medicines-specific advice for ethnic minority populations. [2][3][4]22,29 This codesign research provided a platform to share the voices of members from ethnic minority communities and generate person- appropriate and relevant for all ethnic minority groups, or whether specific communities may benefit from additional, tailored or alternative approaches to best meet their needs.…”

“…There were eight workshops conducted in total; these ran as four pairs of Workshop 1 and Workshop 2. Workshop 1 was designed in such a way as to further explore and validate the findings from two previous qualitative studies by the authors (see Figure 1 and Supporting Information: File) 4,29 . It acted as an opportunity to sense check and assess the face validity of the findings, and for participants to begin identifying core concepts of what constitutes accessibility relating to seeking medicines advice from community pharmacies 27,28 .…”

‘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

“…The interview topic guide (File S1 ) was developed based on three pilot interviews and covered issues identified in previous research, 29 , 37 including participants' experiences of taking medicines; their understanding of medication reviews; their experiences of engaging with these reviews (either in the UK or in their home country); their perspectives of accessing medication reviews; potential barriers or facilitators that affect access; and recommendations for ways to address or improve on challenges. 38 The topic guide was also informed by the lived experiences of patient champions involved in this study (L. S., T. G. and H. K. G.). For the purposes of this study, the exploration of medication review services will include those delivered by pharmacists, as well as other healthcare professional groups.…”