From measuring the right dose of a child’s medicine to recognising serious side effects of an antibiotic, understanding medicine instructions matters. But when vital medical information gets lost across language and cultural barriers, everyday medicine can quickly turn into a safety risk.
A new report has highlighted significant medicine safety challenges facing culturally diverse Australians, prompting calls for greater access to interpreters, multilingual medicine information and pharmacist-led support.
Prepared for the Pharmaceutical Society of Australia by Adelaide University researchers, the report examined medicine use and safety challenges among culturally and linguistically diverse communities, finding that one in three Australians receiving medicines through the Pharmaceutical Benefits Scheme (PBS) were born overseas.
Of particular concern was that nearly half (45 per cent) of PBS medicine recipients who reported limited English proficiency were dispensed six or more medicines – equivalent to around 214,000 people.
Lead researcher Dr Imaina Widagdo from the Quality Use of Medicines and Pharmacy Research Centre said when language needs are not adequately addressed, the risk of medicine-related harm may increase. ‘Taking six or more medicines can be complicated for anyone, but when instructions and important safety information aren’t available in a language you understand, it becomes much harder to use those medicines safely,’ Dr Widagdo said.
‘Something as simple as misunderstanding how much medicine to take, when to take it or what side effects to look out for can have serious consequences. This is not just about translating information. We need to make sure people understand their medicines and have access to culturally appropriate support.’
Key issues
The report highlighted a range of medicine safety issues for culturally and linguistically diverse communities, including:
- Use of high-risk medicines, with 13 per cent of PBS recipients who reported limited English proficiency dispensed blood thinners and 11 per cent opioids.
- Limited awareness of medicine support services, including pharmacist-led Home Medicines Reviews.
- Barriers to accessing and understanding medicine information, particularly when professional interpreters or information in a preferred language were not available.
- Medicines obtained overseas, including through family, friends or online community networks.
- Reliance on family members to interpret medical information, which could lead to misunderstandings about medicine instructions.
- Use of traditional and culturally familiar medicines alongside prescribed medicines.
- Cultural and religious considerations that can affect medicine use, including fasting and restrictions around ingredients such as alcohol or animal-derived products.
‘Rather than assuming everyone approaches medicines in the same way, we need to have conversations about medicine use in a way that is culturally respectful and responsive,’ Dr Widagdo said. ‘Not only is that about asking the right questions but making the time for people to have these conversations. If someone needs more time to understand their medicines and feel confident using them safely, then that time is absolutely worth it.’
Better communication needed
The report calls for professional interpreter use and culturally responsive communication to become standard in medicine care, greater access to multilingual medicine information, increased uptake of pharmacist-led medicine reviews, improved national data on medicine safety in culturally diverse communities, and stronger cultural safety in pharmacist education and practice.
Dr Widagdo said pharmacists were particularly well placed to help bridge these gaps, but greater awareness of available services was needed. ‘Pharmacists can help people understand their medicines, identify potential interactions or other safety concerns, and provide support through services such as Home Medicines Reviews or the MedsCheck program,’ Dr Widagdo said.
‘But these services can only make a difference if people know they exist and can access them in a way that meets their language and cultural needs. Health professionals need to have a complete picture of everything someone is taking – including traditional medicines, complementary medicines and medicines obtained overseas – otherwise potential interactions and other safety risks can be missed.
‘Australia is one of the most culturally diverse countries in the world, and our healthcare system needs to reflect that diversity,’ Dr Widagdo. ‘Safe medicine use shouldn’t depend on how well someone speaks English or how easily they can navigate Australia’s healthcare system.’
