Improving Aboriginal and Torres Strait Islander people's access to medicines — the QUMAX program

Couzos, Sophie; Sheedy, Vicki; Thiele, Dea Delaney

doi:10.5694/j.1326-5377.2011.tb03207.x

Cited by 10 publications

(17 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As one researcher writes, “[c]ontemporary Aboriginal perspectives of hospitals continue to be shaped by the effect of colonisation, creating a depth of fear and anxiety that is difficult for non-Aboriginal people to comprehend.” [29] It has been argued that high DAMA rates reflect an underlying poor response from hospital staff to the needs of Aboriginal patients, with many services failing to recognise and acknowledge their special needs [11,23]. This negative association with health services is also seen through delayed presentation [30,31] and suboptimal uptake and adherence with treatments [32,33]. …”

Section: Discussionmentioning

confidence: 99%

Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease inpatients in Western Australia: an analytic study using data linkage

Katzenellenbogen

Sanfilippo

Hobbs

et al. 2013

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundDischarge Against Medical Advice (DAMA) from hospital is associated with adverse outcomes and is considered an indicator of the responsiveness of hospitals to the needs of Aboriginal and Torres Strait Islander Australians, the indigenous people of Australia. We investigated demographic and clinical factors that predict DAMA in patients experiencing their first-ever inpatient admission for ischaemic heart disease (IHD). The study focuses particularly on the differences in the risk of DAMA in Aboriginal and non-Aboriginal patients while also investigating other factors in their own right.MethodsA cross-sectional analytical study was undertaken using linked hospital and mortality data with complete coverage of Western Australia. Participants included all first-ever IHD inpatients (aged 25–79 years) admitted between 2005 and 2009, selected after a 15-year clearance period and who were discharged alive. The main outcome measure was DAMA as reflected in the hospital record.Multiple logistic regression was used to determine disparities in DAMA between Aboriginal and non-Aboriginal patients, adjusting for a range of demographic and clinical factors, including comorbidity based on 5-year hospitalization history. A series of additional models were run on subgroups of the cohort to refine the analysis. Ethics approval was granted by the WA Human Research and the WA Aboriginal Health Ethics Committees.ResultsAboriginal patients comprised 4.3% of the cohort of 37,304 IHD patients and 23% of the 224 DAMAs. Emergency admission (OR=5.9, 95% CI 2.9-12.2), alcohol admission history (alcohol-related OR=2.9, 95% CI 2.0-4.2) and Aboriginality (OR 2.3, 95% CI 1.5-3.5) were the strongest predictors of DAMA in the multivariate model. Patients living in rural areas while attending non-metropolitan hospitals had a 50% higher risk of DAMA than those living and hospitalised in metropolitan areas. There was consistency in the ORs for Aboriginality in the different multivariate models using restricted sub-cohorts and different Aboriginal identifiers. Sex, IHD diagnosis type and co-morbidity scores imparted different risks in Aboriginal versus non-Aboriginal patients.ConclusionsUnderstanding the risks and reasons for DAMA is important for health system policy and proactive management of those at risk of DAMA. Improving care to prevent DAMA should target unplanned admissions, rural hospitals and young men, Aboriginal people and those with alcohol and mental health comorbidities.

show abstract

Section: Discussionmentioning

confidence: 99%

Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease inpatients in Western Australia: an analytic study using data linkage

Katzenellenbogen

Sanfilippo

Hobbs

et al. 2013

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Reducing out-of-pocket costs for medications may promote their appropriate use and improve medication adherence for Indigenous populations with chronic disease. [9][10][11] Further, evidence suggests that expanded insurance coverage for medications may be offset by reductions in hospitalizations for conditions that are amenable to medication therapy. 12 The extent to which targeted reductions in drug copayments reduced hospitalizations for Indigenous Australians is not known.…”

Section: Introductionmentioning

confidence: 99%

Hospitalizations for Chronic Conditions Among Indigenous Australians After Medication Copayment Reductions: the Closing the Gap Copayment Incentive

Trivedi

Bailie

et al. 2016

J GEN INTERN MED

View full text Add to dashboard Cite

Though we cannot make causal inferences from the results of this study, we observed marked declines in hospitalizations for chronic conditions among Indigenous Australians following targeted reductions in medication copayments for this population. These declines were largely limited to areas with higher uptake of the copayment incentive and were not observed for admissions related to acute conditions.

show abstract

“…These four papers explained the intricacies of each program and the positive effects that they have had for Aboriginal people and their health from the perspective of the authors. These programs are all designed to reduce barriers for access to medications and to improve relationships between patient and provider, to improve medication adherence and reduce hospitalisations for chronic illness 12,16,27 . Papers also talked about pharmacist perspectives of adherence, medication dispensing and barriers 16,28 .…”

Section: Resultsmentioning

confidence: 99%

Scoping review – What do we know about Aboriginal peoples’ use of dose administration aids?

Walke

Barclay

Longman

2022

Health Prom J of Aust

View full text Add to dashboard Cite

Strait Islander peoples have a shorter life expectancy than that of non-Indigenous Australians. [1][2][3] It is important to acknowledge the ongoing impact of colonisation on the considerable disadvantage experienced in this population and the associated health disparities. 4,5 The impacts of colonisation include transgenerational/intergenerational trauma from the effects of the stolen generation, assimilation, forced denial of identity, lack of access to culturally appropriate and

show abstract

Improving Aboriginal and Torres Strait Islander people's access to medicines — the QUMAX program

Cited by 10 publications

References 4 publications

Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease inpatients in Western Australia: an analytic study using data linkage

Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease inpatients in Western Australia: an analytic study using data linkage

Hospitalizations for Chronic Conditions Among Indigenous Australians After Medication Copayment Reductions: the Closing the Gap Copayment Incentive

Scoping review – What do we know about Aboriginal peoples’ use of dose administration aids?

Contact Info

Product

Resources

About