Promoting Healthy Medication Use Through Indigenous Knowledge Sharing: A Coyote Story

Abstract


 
 
 Polypharmacy is the administration of more medications than clinically required or appropriate, and it can negatively impact wellness. Prescribers, pharmacists, nurses, and those receiving care services all have an important role to play in promoting healthy medication use and minimizing the risk related to polypharmacy. Medication management involves health care professionals regularly reviewing drug therapies with patients for any needed changes. This strategy is a key way to reduce the harms of polypharmacy. A review of the First Nations Health Authority Health Benefits Claims data in 2015 confirmed that polypharmacy is an issue for First Nations in British Columbia, Canada. This was further validated in a series of meetings held in four First Nations communities. The learnings from these meetings were that many people do not know the names of their medications, the reasons for taking them, or how to advocate for themselves during health care interactions. A unique strategy was needed to both encourage and empower First Nations and Indigenous people to discuss managing their medications, and to support health care professionals to better understand how to engage First Nations patients about their medications.
 
 

Deprescribing and deimplementation: Time for transformative change

“…Brochures were designed with the input from individuals with lived experience of using these medications, incorporated questions and stories aimed at prompting patients to reevaluate their beliefs about medications and spur them to act, and enabled capability for tapering when appropriate with easy‐to‐follow infographic regimens. This enhanced not only knowledge but also motivation—principles that have been harnessed in subsequent efforts, including storytelling narratives designed for First Nations older adults in Canada that employ familiar characters and motifs from that culture's storytelling traditions 9 . With a number needed to treat of 3, and a reduction in sedative use of 43% over 6 months, the intervention was highly effective.…”

“…This enhanced not only knowledge but also motivation-principles that have been harnessed in subsequent efforts, including storytelling narratives designed for First Nations older adults in Canada that employ familiar characters and motifs from that culture's storytelling traditions. 9 With a number needed to treat of 3, and a reduction in sedative use of 43% over 6 months, the intervention was highly effective. Moreover, cost-effectiveness analyses demonstrated lowered costs for payers while improving quality-adjusted life years for patients-a compelling motivation for payers with potential to implement the intervention widely.…”