Pharmacy Students in Hawaii Get Experience With Unique Patient Populations

In interviews with Pharmacy Times, students from the Daniel K. Inouye College of Pharmacy at the University of Hawaii at Hilo discussed their unique experiences as students in Hawaii. The state has a distinct culture and different patient populations from the mainland United States, and the students said that has led them to have unique perspectives on culturally competent care and pharmacists’ roles in the community.

Analeslie Martinez, fourth-year pharmacy student: There are unique cultural differences, mostly in the sense that there is a highly diverse population here, that may not be seen on the mainland. I believe that real connections are important when considering pharmacy care in the state of Hawaii. It's a really small world here, you know, when you live on an island or a couple of islands, so the relationships that we build with our patients and our health care team is really important. There's been so many times where I'm out in the community event and I see patients or other health care providers that I've worked with who recognize me or I recognize them. And that's very special about being a student and working here, seeing those common faces and showing the patients that you, too, are part of the community. And I really feel like it enhances our relationships with them.

Andrew Schuler, fourth-year pharmacy student: Well, Hawaii has one of the highest homeless populations in which they do not have the necessary access to health care. This causes a problem since preventable diseases and other major health concerns in this population are not being treated in a timely manner, until it becomes so severe that that person ends up in the emergency room, which ends up increasing hospital costs. Affordability is another challenge in Hawaii. Living on an island causes the price of goods to be quite high compared to the rest of the United States. I mean, gas, food, costs of living, making it harder for most of the population to also be able to afford their medication. I mean, it is our responsibility as pharmacists to overcome this barrier. And to really think to ourselves, are the patients being fully adherent to their medications? Are they skipping doses to try and save money? I mean, unfortunately, for most, the answer is yes. Various solutions that pharmacists may come up with are finding cheaper alternative medications, or coupons that will help cover some of the medication cost, or directing patients to an assistive program that help cover the medication cost. I mean, at the end of the day, controlling the patient's blood pressure, glucose levels in a diabetic patient, or preventing someone's asthma attack are the goals that must be met in order to improve the quality of life for the patients in our community.

Being a part of the community with cultural differences is great to see in our community. But that also means that English is not always the first language for everyone living in Hawaii, which may make it difficult for patients to communicate with health care providers or make it difficult to read the instructions on a prescription label. A lot of these patients may end up seeking treatment advice and recommendations from family members or other non-medical experts, which can lead to dangerous outcomes. Again, as health care providers, we need to look out for such barriers. I mean, one example is by using telephone-based services that will help with interpretation. We must make sure that the patient is aware that we are here for them, and we are always going to look out for their best interest.

Taylor Elola, second-year pharmacy student: In such a diverse community like Hawaii, it may be difficult to provide the same care to all cultural, ethnic and socioeconomic backgrounds. It becomes a challenge to pharmacists and other health care professionals to provide culturally competent health care that is open minded and all inclusive. Personally, I find that Hawaii forms a tight knit community despite these diversities, which helps with health compliance and adherence through familial support. When all members of the community are looking out for each other, it makes our job as health care providers easier because that is our main goal to look out for that for others.