Access to medication and pharmacy services for resettled refugees: a systematic review
Kim Bellamy A E , Remo Ostini B , Nataly Martini C and Therese Kairuz DA School of Pharmacy, The University of Queensland, Cornwall Street, Brisbane, Qld 4102, Australia.
B School of Pharmacy and School of Population Health, The University of Queensland, Cornwall Street, Brisbane, Qld 4102, Australia.
C School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Park Road, Grafton, Auckland 1023, New Zealand.
D School of Medicine and Dentistry, James Cook University, Angus Smith Drive, Townsville, Qld 4811, Australia.
E Corresponding author. Email: k.bellamy@uq.edu.au
Australian Journal of Primary Health 21(3) 273-278 https://doi.org/10.1071/PY14121
Submitted: 4 August 2014 Accepted: 21 October 2014 Published: 12 January 2015
Abstract
The difficulties that resettled refugees experience in accessing primary health-care services have been widely documented. In most developed countries, pharmacists are often the first health-care professional contacted by consumers; however, the ability of refugees to access community pharmacies and medication may be limited. This review systematically reviewed the literature and synthesised findings of research that explored barriers and/or facilitators of access to medication and pharmacy services for resettled refugees. This review adhered to guidelines for systematic reviews by PRISMA (preferred reporting items for systematic reviews and meta-analyses). Databases were searched during March 2014 and included Scopus, ProQuest Sociological Abstracts, PubMed, Embase and APAIS Health. The Australian and International grey literature was also explored. Nine studies met the quality and inclusion criteria. The research reported in seven of the nine studies was conducted in the US, one was conducted in Australia and the other in the UK. The majority of studies focussed on South-east Asian refugees. Themes identified across the studies included language and the use of interpreters; navigating the Western health-care system; culture and illness beliefs; medication non-adherence; use of traditional medicine; and family, peer and community support. There is a significant paucity of published research exploring barriers to medication and pharmacy services among resettled refugees. This systematic review highlights the need for appropriate interpreting and translation services, as well as pharmacy staff demonstrating effective cross-cultural communication skills.
Additional keywords: barriers, medicines, primary health care.
References
Australian Government: Department of Health (2009) Primary health care reform in Australia: report to support Australia’s first National primary health care strategy. pp. 1–184. (Commonwealth of Australia: Canberra, ACT)Australia Government: Department of Health (2010) Building a 21st century primary health care system: Australia’s first national primary health care strategy. pp. 1–39. (Commonwealth of Australia: Canberra, ACT)
Australian Government: Department of Immigration and Border Protection (2014) About TIS National. Available at http://www.tisnational.gov.au/About-TIS-National [Verified 12 December 2014]
Berthold SM, Wong EC, Schell TL, Marshall GN, Elliott MN, Takeuchi D, Hambarsoomians K (2007) U.S. Cambodian refugees’ use of complementary and alternative medicine for mental health problems. Psychiatric Services 58, 1212–1218.
| U.S. Cambodian refugees’ use of complementary and alternative medicine for mental health problems.Crossref | GoogleScholarGoogle Scholar | 17766568PubMed |
Clark A, Gilbert A, Rao D, Kerr L (2014) Excuse me, do any of you ladies speak English? Perspectives of refugee women living in South Australia – barriers to accessing primary health care and achieving the Quality Use of Medicines. Australian Journal of Primary Health 20, 92–97.
| Excuse me, do any of you ladies speak English? Perspectives of refugee women living in South Australia – barriers to accessing primary health care and achieving the Quality Use of Medicines.Crossref | GoogleScholarGoogle Scholar | 23482062PubMed |
Corby M (2010) Defining barriers to acceptance of westernized medicine among Montagnard refugees. Explorations, University of North Carolina Wilmington V, 80–94.
Critical Appraisals Checklist (CASP) (2013) Qualitative research checklist. Available at http://media.wix.com/ugd/dded87_951541699e9edc71ce66c9bac4734c69.pdf [Verified 12 December 2014]
Department of Health (2002) The national strategy for quality use of medicines. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/8ECD6705203E01BFCA257BF0001F5172/$File/natstrateng.pdf [Verified 12 December 2014]
Department of Health (2011) Quality use of medicines (QUM). Available at http://www.health.gov.au/internet/main/Publishing.nsf/Content/nmp-quality.htm [Verified 12 December 2014]
Euromed Info (2014) How culture influences health beliefs. Available at http://www.euromedinfo.eu/how-culture-influences-health-beliefs.html/ [Verified 12 December 2014]
Foundation House (2007) Promoting refugee health: a guide for doctors and other health care providers caring for people from refugee backgrounds. Available at http://refugeehealthnetwork.org.au/promoting-refugee-health-a-guide-for-doctors-nurses-and-other-health-care-providers-caring- for-people-from-refugee-backgrounds-3rd-ed/ [Verified 12 December 2014]
Ingar N, Farrell B, Pottie K (2013) Building a welcoming community: the role of pharmacists in improving health outcomes for immigrants and refugees. Canadian Pharmacists Journal 146, 21–25.
| Building a welcoming community: the role of pharmacists in improving health outcomes for immigrants and refugees.Crossref | GoogleScholarGoogle Scholar | 23795164PubMed |
Ito KL (1999) Health culture and the clinical encounter: Vietnamese refugees’ responses to preventative drug treatment of inactive tuberculosis. Medical Anthropology Quarterly 13, 338–364.
| Health culture and the clinical encounter: Vietnamese refugees’ responses to preventative drug treatment of inactive tuberculosis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MvjvVOhuw%3D%3D&md5=8ed4842116fdd2306a374340c0175a66CAS | 10509313PubMed |
Karliner LS, Jacobs EA, Chen AH, Mutha S (2007) Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research 42, 727–754.
| Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature.Crossref | GoogleScholarGoogle Scholar | 17362215PubMed |
Kroll J, Linde P, Habenicht M, Chan S, Yang M, Vang T (1990) Medication compliance, antidepressant blood levels, and side effects in Southeast Asian patients. Journal of Clinical Psychopharmacology 10, 279–282.
| Medication compliance, antidepressant blood levels, and side effects in Southeast Asian patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M7jvFyguw%3D%3D&md5=043c92631c49a58ff0717ab75d6d5559CAS | 2286700PubMed |
Lamb CF, Smith M (2002) Problems refugees face when accessing health services. NSW Public Health Bulletin 13, 161–163.
| Problems refugees face when accessing health services.Crossref | GoogleScholarGoogle Scholar | 12451412PubMed |
Lee A, Buchwald D, Hooton TM (1993) Knowledge and compliance with medications in South East Asian refugees. Journal of Clinical Pharmacy and Therapeutics 18, 199–204.
| Knowledge and compliance with medications in South East Asian refugees.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3szks1Gjtw%3D%3D&md5=7b18f7eeabf99acc61f66724b7da1263CAS | 8345005PubMed |
Lewis C (2007) A hierarchy of medicine: health strategies of elder Khmer refugees in the United States. Qualitative Report 12, 146–165.
McKeary M, Newbold B (2010) Barriers to care: the challenges for Canadian refugees and their health care providers. Journal of Refugee Studies 23, 523–545.
| Barriers to care: the challenges for Canadian refugees and their health care providers.Crossref | GoogleScholarGoogle Scholar |
Murray SB, Skull SA (2005) Hurdles to health: immigrant and refugee health care in Australia. Australian Health Review 29, 25–29.
| Hurdles to health: immigrant and refugee health care in Australia.Crossref | GoogleScholarGoogle Scholar | 15683352PubMed |
Neale A, Ngeow J, Skull SA, Biggs BA (2007) Health services utilisation and barriers for settlers from the Horn of Africa. Australian and New Zealand Journal of Public Health 31, 333–335.
| Health services utilisation and barriers for settlers from the Horn of Africa.Crossref | GoogleScholarGoogle Scholar | 17725011PubMed |
Oxman AD, Guyatt GH (1991) Validation of an index of the quality of review articles. Journal of Clinical Epidemiology 44, 1271–1278.
| Validation of an index of the quality of review articles.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK38%2FksVKktg%3D%3D&md5=e13ee194284aec963a2fde57643d6668CAS | 1834807PubMed |
Parmentier H, Golding S, Ashworth M, Rowlands G (2004) Community pharmacy treatment of minor ailments in refugees. Journal of Clinical Pharmacy and Therapeutics 29, 465–469.
| Community pharmacy treatment of minor ailments in refugees.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crht12nsw%3D%3D&md5=1d15f10f2a1854c36bd5883bc79924b0CAS | 15482391PubMed |
Peterson P, Sackey D, Correa-Velez I, Kay M (2011) Building trust: delivering health care to newly arrived refugees. pp. 1–16. Available at http://materonline.org.au/getattachment/Services/Refugee/Clinical-Resources-and-Publications/Building-trust_-Delivering-health-care-to-newly-ar.pdf [Verified 12 December 2014]
Sheikh-Mohammed M, MacIntyre CR, Wood N, Leask J, Isaacs D (2006) Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. The Medical Journal of Australia 185, 594–597.
Shimada J, Jackson C, Goldstein E, Buchwald D (1995) ‘Strong medicine’: Cambodian views of medicine and medical compliance. Journal of General Internal Medicine 10, 369–374.
| ‘Strong medicine’: Cambodian views of medicine and medical compliance.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28%2Fms1SlsQ%3D%3D&md5=1b75cae7c33547b781f036cebd82db02CAS | 7472684PubMed |
Smith M, Lo W, Bindra J (2013) Prescribing for refugees. Australian Prescriber 36, 146–147.
The Joanna Briggs Institute (2007) Comprehensive systematic review training program manual and workbook. Joanna Briggs Institute, Adelaide.
Yun K, Hebrank K, Graber LK, Sullivan MC, Chen I, Gupta J (2012) High prevalence of chronic non-communicable conditions among adult refugees: implications for practice and policy. Journal of Community Health 37, 1110–1118.
| High prevalence of chronic non-communicable conditions among adult refugees: implications for practice and policy.Crossref | GoogleScholarGoogle Scholar | 22382428PubMed |