Prescribing tips

Written by on . Posted in Approach to patient care

Overview

  • Taking medications correctly requires the use of effective communication techniques to reduce non-adherence, adverse events or failure to take medication as prescribed. Failure to do this increases the risk of medication errors.1
  • Many people from refugee backgrounds, including people seeking asylum, come from areas where pharmaceuticals are poorly regulated and understood.

Approach to care

It is important that the person understands how, why, and when to take the prescribed medication. This can be achieved by:

  • Working with professional interpreting services when necessary.1 See Communication and interpreters.
  • Providing translated material where possible. Note that translated material may not be readily available in all languages, particularly for newly arrived or small communities or language groups.
  • Asking the interpreter to write instructions in the patient’s language.
  • Using diagrams rather than written words; available through online tools such as EASIDOSE and/or images of medications on MIMS on line.
  • Using health literacy principles that confirm the patient’s understanding of how to obtain and use medications correctly in an Australian context. This can be done by another member of the health team, such as the practice nurse.1
  • Explaining the need for long-term prescriptions and the concept of ‘repeat prescriptions’, which may be unfamiliar.
  • Requesting that pharmacists use phone interpreters by specifying this on scripts. For information about fee-free interpreting see Communication and interpreters.
  • Confirming the adherence to medications prescribed; this can mean needing to re-prescribe medicines.

Person-centred prescribing requires understanding about cultural practices and beliefs, values and previous experiences with medications to assess possible impacts on taking medications correctly. For example, people in refugee camps may be used to sharing medicine, and/or not taking the correct dosage because the medicine will last longer and therefore cost is reduced. Education about correct use will need to incorporate the person’s individual needs for information.

Considerations

  • Take into account a patient’s cultural or religious practices. For example, patients of Muslim faith may require halal medications.
  • PBS-listed drug and generic brands are preferable because of their lower cost.1 Consider affordability of medications, including making arrangements for asylum seekers who do not have access to Medicare/concession cards.
  • Some people use herbal or traditional medicines that have the potential to interact with prescribed medicines. Always ask about the use of other traditional and non-prescription medicines.
  • As people move to other areas, especially in the early stages of settlement, it is helpful to supply a list of current medications.
  • A Home Medicines Review for Medicare card holders at risk of medication errors may promote better understanding of medications. See Home Medicines Review.

References

  1. Kay M, Wijayanayaka S, Cook H, Hollingworth S. Understanding quality use of medicines in refugee communities in Australian primary care: a qualitative study. Br J Gen Pract. 2016;66(647):e397-e409.

Produced by

in consultation with

                  Refugee Health Network of Australia

Endorsed by

Funded by

The Australian Refugee Health Practice Guide was produced with funds from the Australian Government Department of Health.

Disclaimer

The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.