Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review

Abstract

There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

Clinical medication review in Australia: A systematic review

“…Data were extracted from nine controlled studies (Table 1), 20-28 34 observational or uncontrolled studies with a focus on MRPs (Table 2), [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] and other clinical, humanistic and economic outcomes (Table 3), 10,44-61 11 qualitative (including interviews and focus groups) and nine survey research studies (Table 4). 11,13,[62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] Methodological quality of studies…”

Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities

“…75 In 268 contrast to quantitative work, which often focus on specific dimensions (i.e., knowledge, 269 attitudes), the qualitative studies take a more in-depth look at pharmacists' experiences related to 270 particular patient populations, including their knowledge, attitudes, beliefs, and perceptions 271 related to working with patients (or potential patients). Notably, although some scholars have 272 examined the patient perspective through surveys e.g.,42, 70,72,81,95,107 and interviews or focus 273 groups, 32,69,77,113,119 or a combinations of methods, 110,116 focused study of patient attitudes, 274 understandings and experiences are less common within this literature. 275…”

“…28,42,48,49,52,70,72,102 Literature on the adequacy of services for racialized 351 populations has considered disparities among racialized groups as related to pharmacy-based 352 immunization, 92,93 pharmacy or medication access, 74,99,121 alignment of pharmacists' activities 353 with patient needs/preferences, 77,81,91,94,102,119 and broader discriminatory practices. 95 Beyond 354 these primary populations, discussion of service adequacy has considered levels of access for 355 those with HIV/ AIDS or Hep C, 30,46 seeking contraception, 32,75 or with limited literacy.…”

“…More specifically, this 248 latter area of research on health care disparities has examined racial/ethnicity differences in 249 immunization rates and other clinical services, 74,[92][93][94][95] reduced access to pharmacies, medications, 250 or services, particularly within rural or poor urban areas, [96][97][98][99] service gaps related to language or 251 health literacy supports, [100][101][102][103][104] or a general lack of interest/willingness of pharmacists to work in 252 underserved areas. 105 Again, there is a body of aligned literature not using the language of 253 disparity, but which shares a focus on service gaps related to provision of accessible labels, 254 services to non-English speaking populations, those with limited literacy, [106][107][108][109][110][111][112][113][114][115][116][117][118][119] or the availability 255 of a full range of medications and/or pharmacy supports in underserved communities. 120,121 M A N U S C R I P T…”

“…A small portion of the literature on accessibility of services overlaps with 357 work on adequacy in terms of population focus, but more often considers the availability of 358 translation services for people with limited English proficiency 100,[102][103][104]106,110,111,115,[117][118][119] or 359 clear communication (including language, visual supports) for people with limited literacy/health 360 literacy. 78,101,107,109,[112][113][114]116 Also addressed are deficits in culturally competent services for those 361 in non-dominant cultural communities 81,108 and logistical service constraints, including 362 "medication deserts" (i.e., limited pharmacy hours, insufficient medication stocks) faced by low 363 income or rural communities.…”