Māori Men and the Indirect Procurement and Sharing of Prescription Medications

Abstract

Māori men have higher rates of many diseases and lower life expectancy than other population groups in New Zealand. The general consensus is that these health inequalities are due to the inequitable distribution of the social determinants of health; for example, education, employment, income and housing, and were largely driven by colonization and the social and economic marginalization of Māori. Health care factors, including reluctance to consult doctors or late presentation, are part of this equation, but do not fully explain the disparities in health between Māori men and other population groups. As part of our ongoing work in this area, we draw on a focus group discussion with seven Māori community health workers to provide a preliminary analysis of how some Māori people access and use medications. Particular attention is given to the emergent practice of Māori women presenting to general practitioners (GPs) with proxy symptoms to obtain medications for their male partners. This practice exemplifies a range of strategies that some whānau (family) have developed to navigate the health system and overcome the reluctance of some men to engage with the medical profession. The practice raises issues relating to the nature of “primary” and “whānau” care, accessibility of medical services and medications, adherence to medication regimes and the dynamics of doctor–patient relations.

A qualitative exploration of healthcare providers’ perspectives on patients’ non‐recreational, prescription medicines sharing behaviours

“…Perhaps, unsurprisingly, participants in our study mentioned a number of influences on patient prescription medicine‐sharing behaviours that could be considered to be cultural factors in the broadest sense, if culture is accepted to include such concepts as ethnicity, geographic location, language and socioeconomic status. These influences have also been reported by others . As noted by Marrone, even if the patient and healthcare provider speak the same language, the experiences and cultural affiliations of the patient may influence their decisions to seek health services, and hence may also influence procurement of medicines.…”

“…These influences have also been reported by others. 18,26 As noted by Marrone, even if the patient and healthcare provider speak the same language, the experiences and cultural affiliations of the patient may influence their decisions to seek health services, 27 and hence may also influence procurement of medicines.…”

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

“…Cultural and legal issues also need to be taken into account. Sharing medications in some cultures can be expressed as care for others when they are ill 29,30. In the USA, this behavior is illegal; a patient cannot lawfully share or borrow prescription pain medication because it is considered pharmaceutical diversion, and a prescriber cannot continue to prescribe when they know that the patient shares the prescribed medication.…”

Sharing of prescription analgesics amongst patients in family practice: Frequency and associated factors

“…Negative aspects include delayed seeking of medical care, increased risk of side effects, health complications associated with incorrect medication or multiplied risk of developing resistance to medication (Goldsworthy and Mayhorn, ; Dimitrov et al., ; Beyene et al., ). Justifiable aspects of this behaviour, as described in literature, include situations where medical aid is unavailable, inconvenience associated with contacting a physician, saving money, lack of faith in physicians, helping patients cope with pain, accessibility of drugs in pharmacies, availability of medication provided by close individuals and maintaining good interpersonal relationships (Hodgetts et al., ; Kamutingondo et al., ; Beyene et al., ; Markotic and Puljak, ; Markotic et al., ). Nonrecreational sharing of medication is mostly motivated by the desire to help others or oneself (Kamutingondo et al., ; Markotic et al., ).…”