The impact of a pharmacist-led cultural competence training on provider perceived preparedness and clinical care in patients with diabetes of Asian descent.

BACKGROUND

Patients of Asian descent are under-represented in the U.S. health care system and provider cultural competence is inadequate in addressing Asian health disparities.

OBJECTIVES

The purpose of this study was to evaluate the impact of the pharmacist-led cultural competence training on provider self-perceived preparedness and diabetes-related health outcomes in patients of Asian descent.

METHODS

This study is a cross-sectional followed by a quasi-experimental design conducted in 2 phases in a primary care clinic. Phase one evaluated the association of providers' cross-cultural care survey (CCCS) scores with patients' diabetic health indices: hemoglobin A1c (HbA1C), systolic blood pressure (SBP), diastolic blood pressure, and body mass index. Phase 2 examined the impact of pharmacist-led cultural competence training on providers' cross-cultural competency using survey analysis as well as pre- and post-training diabetic health indices in patients of Asian descent.

RESULTS

Phase 1 CCCS results showed baseline cross-cultural competence of the providers is inadequate (N = 9 providers). Furthermore, a significant negative correlation was found between providers' CCCS score and patients' HbA1C (N = 49, P = 0.04). Phase 2 showed that cultural competence training significantly reduced providers' self-perceived "un-preparedness" to care for patients of alternative cultures (N = 30 providers). Average diabetic health indices for all patients (N = 95) before and after the training were not significantly different. In the subset of patients with uncontrolled diabetes (HbA1C ≥ 7), SBP and HbA1C were significantly reduced after the training (P = 0.032 and P = 0.039, respectively).

CONCLUSIONS

Pharmacist-led cultural competence training had a positive impact on provider self-assessment and diabetic clinical outcomes in uncontrolled patients.