Medicine Management in Older People from Non‐English Speaking Backgrounds

Abstract

Aim To examine medicine management in older people from non‐English speaking backgrounds (NESB) after discharge from hospital. Method A literature review, followed by focus group discussions with hospital clinicians. Patients 70 years and over from Greek, Chinese, Russian and English speaking backgrounds were interviewed. Case histories were developed based on the interviews and a review of the patients' medical records. Data were clustered and themes extracted. Educational resources were produced for clinicians comprising an action guide and a composite audiovisual case study. These resources were used in further focus group discussions with hospital clinicians to determine current practice for identifying and managing medication management risks for patients from NESB. Results Major themes identified included: patients' lack of knowledge about medications and medication changes; interpreter services not used routinely; and inadequate communication between health professionals. There was little evidence of systematic, standardised processes for identifying people at risk of medicine mismanagement or for the implementation of actions to minimise risks. Conclusion There is a need for effective communication about medications, particularly when patients are transferred from hospital to the community. For people from NESB, this also includes the use of interpreters and translated educational material. A patient journey map and medicine management action guide provides a framework for clinicians to optimise safe medicine management and continuity of care.

Communication relating to family members' involvement and understandings about patients' medication management in hospital

“…Strategies for improved medication management nominated by family members included the use of written lists, which could be updated periodically and the utilization of interpreters. Past research has shown these strategies are effective in improving medication safety, and they have been included in hospital policy guidelines for ensuring good quality care . It is a major concern that these strategies have largely not been implemented or translated into actual practice.…”

Learning from an epidemiological, population‐based study on prescribed medicine use in adults

“…As is common with surveys of this type, the sampling frames excluded people who resided in hospitals and residential care facilities and these groups are known to have high use of medicines. Furthermore, potential medicine‐related problems have been reported in non‐English speaking people, and this group was excluded. However, both surveys would have been affected in a similar manner.…”

Understanding of diagnosis and medications among non‐English‐speaking older patients

“…The majority of patients had poor understanding of the medications they were taking prior to admission. Significantly, NESB patients fared worse compared to their ESB counterparts as previously observed . Possible reasons include the language barrier between doctors and NESB patients precluding the adequate explanation of medications and their purpose.…”