Pharmacy World and Science

, Volume 25, Issue 5, pp 185–190 | Cite as

Accessing medication information by ethnic minorities: barriers and possible solutions

  • E.S. Schaafsma
  • D.K. Raynorr
  • L.T.W. de Jong‐van den Berg


Aim: This review discusses two main questions: how suitable is current consumer medication information for minority ethnic groups, and what are effective strategies to overcome existing barriers. The focus is on minority groups whose first language is not the language of the healthcare system.Method: We searched electronic databases and printed scientific journals focusing on (ethnic) minorities, health and/or (intercultural) communication. We also asked a discussion group for references. Results: We found only a few articles on intercultural communication on medication or pharmacy information and one article on the improvement of intercultural communication in the pharmacy. Barriers to the access of medication information by ethnic minorities include second language issues and cultural differences due to different health beliefs, together with the low socio‐economic status often seen among ethnic minorities. Cultural differences also exist among different socio‐economic classes rather than only among ethnic groups. Most often, informal interpreters are used to improve intercultural communication. However, this may result in miscommunication due to a lack of medical knowledge or training on the part of the interpreter. To minimise miscommunication, bilingual health professionals or health interpreters/advocates can be used, although communication problems may still occur. The effectiveness of written information depends on the literacy skills of the target population. Cultural, medical and dialect biases should be avoided by testing the material. Multimedia systems may be alternatives to conventional written information.Discussion: Barriers that ethnic minorities face in accessing medication information and possible solutions involving counselling and additional tools were identified for pharmacy practice. However, more research is needed to develop effective strategies for patient counselling in pharmacy to meet the needs of ethnic minorities.

Counselling Cross‐cultural communication Ethnic minorities Intercultural communication Medication information Oral information Patient education Pharmacy Written information 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rantucci MJ. Pharmacists Talking with patients. A guide to patient counselling, 1st ed, Baltimore, Maryland: Williams & Wilkins, 1997.Google Scholar
  2. 2.
    Ley P. Communicating with patients. New York: Croom Helm, 1988.Google Scholar
  3. 3.
    Raynor DK. The influence of written information on patient knowledge and adherence to treatment. In: Myers LB, Midence K, editors. Adherence to treatment in medical conditions. Amsterdam: OPA/Harwood Academic Publishers, 1998: 83–112.Google Scholar
  4. 4.
    Royal Pharmaceutical Society. From compliance to concordance. London: Royal Pharmaceutical Society Great Britain (RPSGB), 1997.Google Scholar
  5. 5.
    Veenman J. Participatie en perspectief. verleden en toekomst van ethnische minderheden in nederland. [Participation and perspectives. History and Future of Minorites in the Netherlands.] Houten, The Netherlands: Bohn Stafleu Van Loghum/Koninklijke Vermande, 1999.Google Scholar
  6. 6.
    Aslam M, Wilson J, Jessa F. Ethnic minorities. In: Taylor K, Harding G, editors. Pharmacy practice, 1st ed. London: Taylor & Francis, 2001: 274–87.Google Scholar
  7. 7.
    Jandt FE. Intercultural communication. An introduction, 3rd ed. Thousand Oaks, California: Sage Publications, 2001.Google Scholar
  8. 8.
    Durgunoglu AY, Verhoeven L. Literacy Development in a multilingual context. Cross-cultural perspectives. Mahwah, New Jersey: Lawrence Erlbaum, 1998.Google Scholar
  9. 9.
    Shadid WA. Grondslagen van de interculturele communicatie. Studieveld en werkterrein. [Fundamentals of intercultural communication. Theory and practice.] Houten, The Netherlands: Bohn Stafleu Van Loghum, 1998.Google Scholar
  10. 10.
    Health education of Asian immigrants. BMJ 1967; 4: 187–8.Google Scholar
  11. 11.
    Schaafsma ES, Wolschrijn H, Paes AHP. Geneesmiddelenvoorlichting aan vluchtelingen. [Medication information for refugees.] Pharm Weekbl 1997; 132(48): 1840–4.Google Scholar
  12. 12.
    Chachkes E, Christ G. Cross-cultural issues in patient education. Patient Educ Couns 1996; 27: 13–21.Google Scholar
  13. 13.
    Jandt FE. Knowing Culture through language. Intercultural communication. An introduction, 3rd ed. Thousand Oaks, California: Sage Publications, 2001:125–46.Google Scholar
  14. 14.
    Saini F, Rowling L. It's more than literacy: the assimilation effect of the translation model. Ethnicity Health 1997; 2(4): 323–9.Google Scholar
  15. 15.
    Jandt FE. Language as a barrier. Intercultural communication. An introduction, 3rd ed. Thousand Oaks, California: Sage Publications, 2001: 147–78.Google Scholar
  16. 16.
    Paes AHP, Dettingmeijer MS. Geneesmiddelenvoorlichting aan allochtonen. [Medication information for ethnic minorities.] Pharm Weekbl 1997; 132: 481–5.Google Scholar
  17. 17.
    Goodyer L, Savage I and Dikmen Z. The influence of multimedia and other educational strategies on metered dose inhaler technique, Report, 2001.Google Scholar
  18. 18.
    Elderkin-Thompson V, Silver RC, Waitzkin H. When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. Soc Sci Med 2001; 52(9): 1343–58.Google Scholar
  19. 19.
    Erzinger S. Communication between Spanish-speaking patients and their doctors in medical encounters. Cult Med Psychiatry 1991; 15: 91–110.Google Scholar
  20. 20.
    Byrant DE. The impact of language and culture on health care [dissertation]. 1999.Google Scholar
  21. 21.
    Nazneen K. Language barriers to health care: cost-benefit analysis of providing interpreter services at healthcare settings [dissertation] 1998Google Scholar
  22. 22.
    Worley L, Elder C. Miscommunication in the medical encounter: a function of language or social roles? Aust Rev Appl Linguistics 1991; 14(1): 17–34.Google Scholar
  23. 23.
    Verrept H. Interculturele bemiddeling: de oplossing voor problemen in de hulpverlening aan allochtonen? [Intercultural advocacy, solution for problems in counseling ethnic minorites?] In: De Muynck A, Timmerman C, Straetemans H, editors. Interculturele communicatie in de gezondheidszorg. [Intercultural communication in health care.] Amersfoort, The Netherlands: Acco, 1998: 89–100.Google Scholar
  24. 24.
    Seijo R, Gomez H, Freidenberg J. Language as a communication barrier in medical Ccare for hispanic patients. Hispanic J Behav Sci 1991; 13: 363–76.Google Scholar
  25. 25.
    Pochhaker F. Language barriers in Vienna hospitals. Ethnicity Health 2000; 5(2): 113–9.Google Scholar
  26. 26.
    Shadid WA. Interculturele hulpverlening. [Intercultural counseling.] In: Shadid, W.A. Grondslagen van de interculturele communicatie. Studieveld en werkterrein. [Fundamentals of intercultural communication. Theory and practice.] Houten/Diegem, The Netherlands: Bohn Stafleu Van Loghum, 1998: 233–61.Google Scholar
  27. 27.
    Pyrczak F. Reading comprehension of directions on medication. Reading Improvement 1973; 10(2): 32–3.Google Scholar
  28. 28.
    Marshall CE, Richards J. Developing culturally-based patient education materials for non-reading, elderly Hispanics. Techtrends 1989; 34: 27–30.Google Scholar
  29. 29.
    Gailly A. Cultuur en communicatie. [Culture and communication.] In: De Muynck A, Timmerman C, Straetemans H, editors. Interculturele communicatie in de gezondheidszorg. [Intercultural communication in health care.] Amersfoort, The Netherlands: Acco, 1998: 27–42.Google Scholar
  30. 30.
    Bell JH, Johnson RE. Effect of lowering the reading level of a health education pamphlet on increasing comprehension by ESL adults. TESL Canada J 1992; 10: 9–26.Google Scholar
  31. 31.
    Sless D, Wiseman R. Writing about medicines for people. Usability guidelines for Consumer Medicine Information, 2nd ed. Canberra: Department of Health and Family Services & Communication Research Institute of Australia, 1997.Google Scholar
  32. 32.
    Promoting Excellence in Consumer Medicine Information (PECMI) group. Retrieved from on 3 July 2002Google Scholar
  33. 33.
    Dowse R, Ehlers MS. Pictograms in pharmacy. Int J Pharm Pract 1998; 6: 109–18.Google Scholar
  34. 34.
    Adamo N, Jacobs NE, Mokkink HGA. Schriftelijke voorlichting in de eerstelijn: effectief of niet? [Is written information in primary health care effective?] Huisarts en Wetenschap 2000; 43(10): 434–7.Google Scholar
  35. 35.
    Sliosberg A. Considerations sur la traduction medicale et pharmaceutique. [Considerations on medical and pharmaceutical translation.] Etudes de Linguistique Appliquee 1973; 12: 85–94.Google Scholar
  36. 36.
    Chesher T. Translation for public health education. Koine 1994; 4: 35–47.Google Scholar
  37. 37.
    Clabots RB, Dolphin D. The multilingual videotape project: community involvement in a unique health education program. Public Health Rep 1992; 107(1): 75–80.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • E.S. Schaafsma
    • 1
    • 2
  • D.K. Raynorr
    • 3
  • L.T.W. de Jong‐van den Berg
    • 2
  1. 1.Science Shop for MedicinesUniversity of GroningenThe Netherlands
  2. 2.Department of Social Pharmacy, Pharmacoepidemiology and PharmacotherapyUniversity of GroningenThe Netherlands E‐mail
  3. 3.Division of Academic Pharmacy PracticeUniversity of LeedsUK

Personalised recommendations