| Project Objectives / Summary:
Lack of concordance with prescribed medication therapy is a common and accepted reason for poor and variable drug treatment response. There is a real need to better understand concordance amongst ethnic communities, to identify ethnic-specific barriers to optimal concordance, and to develop strategies which GPs can use in partnership with their patients to overcome these barriers.
The project targeted the Chinese and Arabic populations, two groups which represent the largest ethnic minorities in the participating divisions. They are also thought to be sufficiently different that themes and methods common to both groups may be worthy of further exploration with other ethnic groups.
The objectives of the project were to:
- Explore issues that impact upon concordance in NESB communities.
- Identify strategies which may contribute to the best practice management of these issues.
- Identify possible generic elements of these approaches in order to create models for intervention with NESB communities.
- Explore a model of collaboration between participating divisions which benefits from their complimentary skills and experiences, minimises duplication of efforts, and enhances their existing relationship.
Project Collaboration:
This was a collaborative project between the Canterbury, Bankstown & St George Divisions of General Practice.
Project Outcomes:
The project strengthened collaborative arrangements between the two Divsions and other stakeholders.
Concordance with prescribed medication is clearly a problem area for both the Chinese and Arabic communities. The Chinese community tend to be more reliant on Traditional Chinese Medicine and more inclined to avoid Western medication. The Arabic community tend to 'over rely' on the GP and prescribed medication.
While there are some issues where the communities differ markedly in their approach, there are others where they are similar eg issues connected with sharing medication, self medication, the language barrier, cost and the limited time spent by GPs with patients.
Recommendations:
- The project identified the following as possible solutions / strategies:
- Engage, train and recruit community representatives from the Arabic and the Chinese community to voice concerns
- Utilise the ethnic media to inform consumers about appropriate medication taking behaviour
- Use Division newsletters to educate GPs about useful tips to prescribing for consumers from NESB
- Consumers and GPs to be actively involved in the implementation process of solutions
- Develop a strategy to evaluate the clinical effectiveness of the implementation of prospective solutions
- Collaboration of work with pharmacist and health workers to create awareness among the Arabic and the Chinese community about relevant and new information
- Create a database of local Arabic and Chinese speaking GPs and pharmacists for people from Arabic and Chinese speaking backgrounds to access
- Implementing accessible translation and interpretation strategies
Provide continuous consultation and evaluation of the process with consumers, health professionals and GPs
- Establish a cultural sympathy between the main stream health care system and the alterative treatment
- The potential solutions expressed demonstrate that ethnic specific issues need further investigation than permitted by the time and budgetary constraints of this project. A deeper examination of the issues may reveal the extent of the problems experienced in the Arabic and the Chinese community.
This project identified the need for more consumer participation in order to improve the quality of care.
Lessons / Assessment:
The duration of this project was very short which places a distinct limit on its overall scope.
It appears that it was easier to recruit GPs in the St George Division than in the other two Divisions and this was due to the more established relationships over Traditional Chinese Medication in the St George area.
The project outcomes do not appear to be surprising. Similarly, the recommendations represent a basic common sense approach.
This project represents a stepping stone rather than a leap forward. |
