Document Type : Original Article

Authors

1 School of Pharmacy, Griffith University, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia

2 Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia

3 School of Pharmacy, Griffith University, Gold Coast, Queensland, Australia

4 School of Pharmacy, Griffith University, Gold Coast, Queensland, Australia Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia

Abstract

Objective: Overcoming language and cultural barriers is becoming ever challenging for 
pharmacists as the patient population grows more ethnically diverse. To evaluate the current 
practices used by the pharmacists for communicating with patients with limited English 
proficiency (LEP) and to assess pharmacists’ knowledge of, attitude toward, and satisfaction 
with accessing available services for supporting LEPs patients within their current practice 
settings.
Methods: Semi‑structured interviews were conducted with five pharmacists employed in 
pharmacies representing multiple practice settings Queensland, Australia. Thematic analysis 
was primarily informed by the general inductive approach. NVivo software (QSR International 
Pty Ltd.) was used to manage the data.
Findings: Three interlinked themes emerged from the analysis of interview data: (1) Barriers 
to the provision of pharmaceutical care,(2) Strategies employed in dealing with LEP patients, 
and (3) Lack of knowledge about existing services. Pharmacists recognized their lack of 
skills in communicating with LEP patients to have potential negative consequences for the 
patient and discussed these in terms of uncertainty around eliciting patient information 
and the patient’s understanding of their instructions and or advice. Current strategies were 
inconsistent and challenging for LEP patient care. While the use of informal interpreters 
was common, a significant degree of uncertainty surrounded their actual competency in 
conveying the core message.
Conclusion: The present study highlights a significant gap in the provision of pharmaceutical 
care in patients with LEP. Strategies are needed to facilitate quality use of medicines among 
this patient group.

Keywords

1. Bradshaw M, Tomany‑Korman S, Flores G. Language barriers 
to prescriptions for patients with limited English proficiency: 
A survey of pharmacies. Pediatrics 2007;120:e225‑35.
2. Multicultural Community Quality Use of Medicines 
Program. Federation of Ethnic Communities’ Councils of 
Australia. Available from: http://www.fecca.org.au/projects/
past‑projects/multicultural‑community‑quality‑use‑of‑medic
ines-program. [Verified on 2015 Feb 05].
3. Yeo S. Language barriers and access to care. Annu Rev Nurs 
Res 2004;22:59‑73.
4. Burnes Bolton L, Giger JN, Georges CA. Structural and racial 
barriers to health care. Annu Rev Nurs Res 2004;22:39‑58.
5. Kundhal KK, Kundhal PS. MSJAMA. Cultural diversity: An 
evolving challenge to physician‑patient communication. 
JAMA 2003;289:94.
6. Hepler CD, Strand LM. Opportunities and responsibilities in 
pharmaceutical care. Am J Health Syst Pharm 1990;47:533‑43.
7. Communication and Cultural Issues in Informed 
Decision‑Making in Clinical Healthcare. Queensland Health 
Guide to Informed Decision‑making in Healthcare. Available 
from: http://www.health.qld.gov.au/consent/documents/
ic‑guide.pdf. [Verified on 2015 Feb 05].
8. NVivo Qualitative Data Analysis Software; QSR International 
Pty Ltd. Version 10, 2012.
9. Thomas DR. A general inductive approach for analysing 
qualitative evaluation data. Am J Eval 2006;27:237‑46.
10. Pharmacists Can Help Prevent Medicines‑Related Problems 
Australians. Available from: http://www.nps.org.au/
media‑centre/media‑releases/repository/Pharmacists‑ca
n‑help‑prevent‑medicines‑related-problems‑Australians. 
[Verified on 2015 Feb 05].
11. Chang E, Tsang B, Thornley S. Language barriers in the 
community pharmacy: A survey of Northern and Western 
Auckland. J Prim Health Care 2011;3:102‑6.
12. Australian Government Department of Social Services. 
Settlement Reports: Top 25 Languages by Migration Stream.
13. Cleland JA, Watson MC, Walker L, Denison A, Vanes N, 
Moffat M. Community pharmacists’ perceptions of barriers 
to communication with migrants. Int J Pharm Pract 
2012;20:148‑54.
14. Australian Government Department of Immigration and Border 
Protection. Available from: https://www.tisnational.gov.au/
Non‑English‑speakers/Help‑using‑TIS‑National‑services/
Agencies‑and‑businesses‑using‑TIS‑Nationalinterpreters. [Verified on 2015 Feb 06].
15. Phillips C. Using interpreters – A guide for GPs. Aust Fam 
Physician 2010;39:188‑95.
16. Gray B, Hilder J, Donaldson H. Why do we not use trained 
interpreters for all patients with limited English proficiency? 
Is there a place for using family members? Aust J Prim Health 
2011;17:240‑9.