Implementing and Delivering Culturally Centred Pharmacy Services Tailored to Ethnically Minoritised Populations: A Qualitative Systematic Review and Meta-Ethnography.

INTRODUCTION

Health inequities disproportionately affect people from ethnic minority communities and require a comprehensive effort across healthcare disciplines to tackle them. Ethnically minoritised populations continue to be underserved, despite the growing awareness of the detrimental link between ethnicity and poorer health- and medication-outcomes. Pharmacy has been recognised as an accessible and inclusive healthcare setting, with the ability to meet diverse patient needs. Yet, there still remain distinct gaps in knowledge of how to best design, implement and deliver culturally centred pharmacy services for members of ethnic minority communities.

METHODS

A systematic literature search was undertaken in November 2023, across four databases: MEDLINE, Embase, CINAHL and PsycINFO. Qualitative studies were included if they addressed barriers, enablers and interventions aimed at tackling medicines- and health service inequalities affecting people from ethnic minority communities. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were synthesised using a meta-ethnographic approach, according to Noblit and Hare, forming a qualitative evidence synthesis to further understanding.

RESULTS

This meta-ethnographic systematic review synthesised data from 13 international studies eligible for inclusion. Four overarching third-order constructs (termed 'themes') were developed through reciprocal translation and focused on: (i) navigating pharmacy systems across the globe; (ii) understanding cultural needs and beliefs that may influence medicine use; (iii) strengthening relationships with pharmacists and other healthcare providers and (iv) addressing possible language and communication barriers.

CONCLUSION

Pharmacists and policymakers should aim to raise awareness of pharmacy services, increase the provision of cultural competency training within the profession, build stronger relationships with minority communities, and facilitate access to interpretation services. A template of recommendations has been developed to further implement and deliver such services on an individual pharmacy-, community- and profession-basis. Future research should seek to utilise lived-experience narratives and participatory co-design methods to further explore ways to address wider healthcare accessibility inequalities for this minoritised population.

PATIENT OR PUBLIC CONTRIBUTION

Public contributors and authors (inequity research champions, G.K. and T.G.) informed and shaped this project during study design and conceptualisation; they helped to ensure that the study was conducted, and the findings were reported, with sensitivity.