Tip of the Week: Cultural Competence in Providing Care

Providing quality care means providing culturally competent care. When communicating with, providing treatment for, or interacting in any way with a patient who is different than you (by culture, race/ethnicity, gender, age, belief system, or other), you will be less effective in doing so without a better understanding of that patient’s perspectives. Understanding their perspectives also will help engender their trust and loyalty, which affect positively their treatment outcomes and your pharmacy business.

In the United States racial/ethnic minority populations account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity. Interventions with a proven track record, when examined using comparative effectiveness research, are often not adopted or used for these patients.

A study published in the Journal of Public Health Management & Practice sought to assess implementation and effects of comparative effectiveness research-proven interventions translated for minority communities at a federally qualified community health center in Chicago, Illinois, and in a group of public housing facilities for seniors in Houston, Texas. The authors employed virtual training institutes wherein intervention staff learned cultural competency methods of adapting effective interventions. Health educators delivered the Health Empowerment Lifestyle Program (HELP) in Chicago; community pharmacists delivered the MyRx Medication Adherence Program in Houston.

Participation rates, satisfaction with interventions, and pre- to post-intervention changes in knowledge, diet, and clinical outcomes were analyzed in the study. In Chicago, patients experienced statistically significant reductions in hemoglobin A1c and systolic blood pressure, increased knowledge of hypertension management, and improved dietary behaviors. In Houston, subsidized housing residents had improvements in knowledge of self-management and adherence to medication for diabetes and hypertension, and showed high levels of participation in pharmacist home visits and group education classes.

Adaptation, adoption, and implementation of HELP and MyRx demonstrated important post-intervention changes among various racial/ethnic populations in Chicago and Houston. The results were positive but suggested the need for implementation studies of longer duration to sustain long-term interventions on a community-wide scale.

While individual pharmacists have to take considerable responsibility for honing their cultural competence skills, managers can and should make hiring decisions based in part on employees’ cultural competence, can establish mission and values statements that embrace cultural competence, and establish an organizational structure that rewards cultural competent care and likewise market this to potential clients. In other words, cultural competence promotes better treatment outcomes, higher esteem for the profession, and greater loyalty from patients.

Additional information about medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.

REFERENCE

Rashid JR, Leath BA, Truman BI, et al. Translating comparative effectiveness research into practice: Effects of interventions on lifestyle, medication adherence, and self-care for type 2 diabetes, hypertension, and obesity among Black, Hispanic, and Asian residents of Chicago and Houston, 2010 to 2013. J Public Health Manag Pract. 2017;23:468-476.