Pharmacists' experience of asthma management in culturally and linguistically diverse (CALD) patients

Abstract

Background: In Australia, one of the world's significantly multicultural nations, asthma is one of the most common chronic conditions. A significant level of health disparities have been observed in many countries with a culturally and linguistically diverse demography. Previous studies have identified that language and culture affect health care provision, this is why culturally competent care is crucial when managing chronic conditions in diverse populations.

Objective: The purpose of this study was to explore Australian community pharmacists' experience and perspective about providing care for CALD people with asthma.

Methods: Qualitative semi-structured interviews were used as the method of choice to fulfil the study objective. Participants were recruited purposively from suburbs of relative diversity in two Australian cities: Melbourne and Sydney. Interviews with consenting pharmacist were conducted using an interview guide. Verbatim transcripts of interviews were then thematically analysed.

Results: Thirty-two interviews resulted in five emergent themes 1) Pharmacists' attitudes towards CALD patients and Cultural Competence; 2) Barriers and facilitators; 3) Clinical issues; 4) Cultural barriers; 5) Workarounds. It was evident that language and to a smaller extent, cultural barriers were experienced regularly by pharmacists managing CALD patients; pharmacists had mostly adapted with a range of methods to work around these barriers. Although pharmacists had a positive attitude, there seemed to be a need for enhanced cultural competence skills; reflections from pharmacists supported the need for further training and pharmacy specific resources.

Conclusions: There is a significant gap in cultural awareness among Australian pharmacists. Future direction suggests obligatory training in cultural competence for health professionals in order to be able to provide cultural proficient care.

Keywords: Asthma management; CALD; Community pharmacy; Cultural beliefs; Health literacy; Pharmacists attitudes.