Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

Pernille Dam Hanne Herborg

doi:10.4172/2376-0419.1000128

Abstract

Background: From studies, we know how ethnic minorities and people with reduced work ability often suffer from health problems, thus being socially disadvantaged. The municipal job centers are confronted with numerous problems related to medicine use and they lack relevant means of referral. Thus, there was a need to adapt a previously developed and validated medicine-based intervention “safe and effective use of medicines” to this vulnerable group of unemployed ethnic minority patients. Methods: The objective of this before-after study was to improve medicines adherence, health status and work ability of the target group through an individualized pharmacist delivered intervention with focus on safe and effective implementation of medical treatments. The target group was ethnic minorities of non-western origin affiliated with a job center. Results: At baseline, 35.7 % of the patients had a potential adherence behavior problem Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation (having an average adherence score of less than 5); at endpoint, this number had decreased to 27.3 %, meaning that 8.4 % no longer had potential adherence problems. Self-reported adherence was significantly improved on three out of four subscales (“Intentional, selfregulation” from 4.5 to 4.7, p=0.016); “Unintentional” from 3.9 to 4.2, p=0.009); “Intentional, effect-related” from 4.0 to 4.4, p=0.025; “General” 4.3 to 4.5, p=0.173.). On average, 47 % of the patients experienced improvements in concordance, due to the intervention. Conclusion: The counseling program “Safe and effective use of medicines” was successfully adapted to unemployed ethnic minority patients, and tested in a new collaboration between job centers and community pharmacies. The counseling program resulted in statistically significant improvements in self-reported adherence as well as improved concordance for approximately half of the patients. Improvements in adherence removes one barrier for returning to the work force that exists in the complex interaction between adherence, health status and work ability.

Highlights

Ethnic minorities and people with reduced work ability often suffer from health problems and a high unemployment rate, being socially disadvantaged [1]
Eighty-two patients participated in the counseling program; 51 (62.2 %) completed both the baseline and the endpoint questionnaire
The remaining patients (38 %) either dropped out or were discontinued by the pharmacist who found no reasons to continue with the sessions

Summary

Introduction

Ethnic minorities and people with reduced work ability often suffer from health problems and a high unemployment rate, being socially disadvantaged [1]. Musculoskeletal disorders and cardiovascular diseases are some of the most prevalent reasons for unemployment and disability income benefits They experience physical, economical, temporal and mental barriers against being active in restoring or maintaining their health. Professionals working with unemployment groups point to the need for progressing slowly when promoting health among socially disadvantaged groups [6]. As patients, such groups need multidimensional interventions and tailored solutions taking into account the multifaceted causes of their medication-related problems [1]. There was a need to adapt a previously developed and validated medicine-based intervention “safe and effective use of medicines” to this vulnerable group of unemployed ethnic minority patients

Objectives

Methods

Results

Discussion

Conclusion