Practicing Cultural Competence in the Pharmacy
Key takeaways:
Cultural competence is an essential skill in our increasingly diverse society.
For healthcare professionals, providing quality patient care includes a deep respect and understanding of patients’ cultural differences and beliefs.
Culturally competent pharmacists improve medication adherence and health outcomes in diverse patient populations.
According to the 2020 U.S. Census, over 40% of the U.S. population belongs to a racial or ethnic minority group. With the U.S.’ increasingly diverse population, it is necessary for healthcare professionals to understand diverse cultural backgrounds and beliefs to deliver quality patient care.
Social determinants of health, the nonmedical factors that influence health outcomes for an individual, contribute to stark inequities in access to care and health disparities. People from racial and ethnic minority groups experience an unequal burden of chronic health issues and preventable illnesses when compared to nonminorities.
According to the 2021 National Healthcare Quality and Disparities Report, profound disparities exist among minority communities across all domains of healthcare quality. Providing culturally competent care can help reduce health disparities. And it can also give diverse populations greater access to care.
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Here, we’ll define cultural competence and explore its value in healthcare as well as its impact in the pharmacy setting.
What is cultural competence?
The U.S. Health and Human Services Office of Minority Health defines cultural competence as “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.”
Culturally competent care recognizes the cultural factors that can affect a person’s health and influence their treatment decisions. Some examples include communication preferences, language, beliefs, and behaviors.
Why is cultural competence important in pharmacy practice?
Pharmacists are key and accessible members of the healthcare team. And they have an important role in reducing health disparities related to medication use. The American Society of Health-System Pharmacists (ASHP) Code of Ethics and the American Pharmacist Association (APhA) Oath of a Pharmacist both highlight the importance of respecting cultural differences and embracing diversity to advance health equity in the pharmacy setting.
Lack of cultural understanding between a patient and pharmacist can cause confusion about how to use a medication appropriately. As a result, medication errors may happen. For example, failure to offer medication counseling in a patient’s preferred language may lead to medication nonadherence or dosing problems. This might result in poor medication efficacy or even toxicity. Studies have shown that offering language interpreter services in pharmacy settings improves patient understanding, communication, medication adherence, and clinical outcomes.
Besides accommodating linguistic differences, culturally competent care also involves acknowledging and respecting patients’ personal beliefs and behaviors that affect their health. For example, a patient may prefer to use herbal products, other alternative therapies, religious practices, or spiritual traditions to treat their illness. Pharmacists should acknowledge these preferences and make efforts to include them in the patient’s drug treatment plan. Patients are more likely to follow a treatment plan that respects and embraces their cultural traditions.
Tips for becoming a culturally competent pharmacist
Self-assessment is an important first step in identifying your current cultural competence practices and areas for growth.
The Self-Assessment Checklist for Personnel Providing Primary Healthcare Services, created by Georgetown University, is a comprehensive questionnaire that measures domains. These include areas, like physical environment, materials and resources, communication style, and values and attitudes.
Patient assessment tools can help identify cultural differences that may exist between patients and clinicians. Arthur Kleinman’s Eight Questions were designed to help clinicians understand a patient’s cultural perspective and beliefs about their condition and treatment goals. And they also help clinicians identify and address cross-cultural communication barriers. The questions include:
What do you call your problem? What name does it have?
What do you think caused your problem?
Why do you think it started when it did?
What does your sickness do to you? How does it work?
How severe it is? Will it have a short or long course?
What do you fear most about your disorder?
What are the chief problems that your sickness has caused for you?
What kind of treatment do you think you should receive? What are the most important results you hope to receive from treatment?
Effective cross-cultural communication is another key part of achieving cultural competence in the pharmacy setting. Consider the following approaches:
Watch both verbal and non-verbal communication cues during patient interactions.
Use the teach-back method to measure a patient’s understanding of given information.
Use trained language interpreters whenever necessary.
Use vocabulary and terminology that is culturally appropriate for the patient.
Learn about the culture and communication preferences in the community of your practice.
The bottom line
With the U.S.’ increasingly diverse population, it is more important than ever for pharmacists and other health providers to apply cultural competence practices in patient care. Culturally competent care improves medication adherence, reduces potential errors related to cross-cultural miscommunication, and improves health outcomes in diverse patient populations.
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