Pharmacists can help improve medicine literacy

Helping consumers understand the language of medicines is the key message to emerge from this year’s Be Medicinewise Week.

To improve this understanding, PSA encourages all consumers to talk to their pharmacist.

‘As medicine experts, pharmacists speak the language of medicines and can help patients not only increase their health literacy, but empower them to be active participants in their health care,’ said PSA National President Dr Chris Freeman.

‘This, in turn, will help reduce medicine-related problems and improve patient health outcomes.’

In a webinar launching the event, NPS MedicineWise medical adviser Dr Jill Thistlethwaite cited key findings from PSA’s Medicine Safety report to highlight the dangers of medicine misadventure.

‘There are 250,000 hospital admissions each year as a result of medicine-related problems. And 400,000 additional presentations to emergency departments, which are likely due to medicine-related problems such as double dosing,’ she said.

Dr Thistlethwaite also cited recent data from a YouGov Galaxy poll conducted by NPS MedicineWise of 1,037 adults, highlighting the gaps in consumers’ medicine literacy that can lead to adverse events.

Around half (527 respondents) regularly take two or more medicines and only 31% keep a list of all their medicines – whether they be prescription, over-the-counter or complementary. Almost half (40%) don’t keep a list of any medicines and only 16% are able to identify the active ingredient in their medicines.

Strong medicine literacy entails having a list of all medicines, how and when they should be taken, the dosing method and a good understanding of the active ingredients and what they do, Dr Thistlethwaite said.

To emphasise why confusion around medicine use can occur, two pharmacists from an urban and rural setting discussed the language and cultural barriers they have encountered, and how pharmacists can help.

Urban cultural barriers

Community pharmacist Veronica Nou, owner of Morris Care Pharmacy and Colyton Centre Pharmacy in western Sydney, serves both culturally and linguistically diverse communities. Although language is the cause of the most obvious barrier, cultural beliefs often get in the way. 

‘When people come into the pharmacy – whether on a daily, weekly or fortnightly basis – we often have to put in a lot of extra effort to overcome these preconceptions and ideas,’ she said.

Embarrassment about a condition or lack of English skills is something Ms Nou encounters regularly.

‘We’ve spoken to a young Iranian women who was a little embarrassed to have developed thrush. Because of her embarrassment, she was too shy to ask how to use her treatment,’ she said.

‘Not until she came in to see us complaining that she had the worst stomach ache and she didn’t at all like the greasy sensation in her throat did we ascertain that she had been drinking the medicine rather than using it how it was supposed to be used.’

Ms Nou stated she has observed the confusion around medicine use lead to far more serious issues. 

A Hazara refugee with post-traumatic stress who took antidepressants for her condition was hospitalised due to a medication error. Unable to comprehend English, she relied heavily on her primary school-aged children to relay information about her medicine as she was too embarrassed to ask for additional help. As a result, she was taking a dose four times the required amount.

To avoid such instances, Ms Nou’s said it’s important that consumers are aware that it’s a pharmacist’s job to listen and help them to use their medicines safely: ‘This NPS Medicinewise week, we want to emphasise that no matter what it is, whether it’s something that’s a little embarrassing or that you wouldn’t necessarily discuss – pharmacists are here for you. We are not too busy for you and we want to take the time to talk to you,’ she said.

‘If there is a language difficulty there are resources like the ATIS [Automated Telephone Interpreting Service] which has interpreting services that we can organise for you.’

Remote confusion

Heather Mann is a community pharmacist and founder of Kimberley Pharmacy Services, which has three sites in the Kimberley serving people in 28 Aboriginal communities.

Much of the confusion she identifies is around the way medicines work and how they should be taken.

‘There’s not a one-size fits all way to explain how medicines work. It’s really important that people feel comfortable to ask questions, so that the explanations they are given are appropriate to their understanding,’ Ms Mann said. 

‘A big area of the work I do is around time of day and when people should take their medicines.’ 

Ms Mann said a survey used to inform a community engagement strategy helped her team identify the appropriate language and symbols to indicate when a medicine should be taken.

‘Normally the dose administration aids we use have breakfast, lunch, dinner and bedtime [time slots], and for symbols we picked a sunrise, a sun high in the sky, a sunset and a moon,’ she said.

One person who considered ‘dinner’ his midday meal, took his medicine four or five hours apart rather than at 12-hourly intervals. Another who didn’t understand the wording on his medicine label was worried about missed doses so took all of his medicine at once, leading to serious side effects.

Ms Mann emphasised the importance of overcoming confusion by identifying the right way to communicate with people. 

‘The language health professionals use is critical to having conversations with people around issues such as the time of day their medicine should be taken and what that actually means.’