Chronic disease, medications and lifestyle: perceptions from a regional Victorian Aboriginal community

Keywords: Oceanic Ancestry Group, Health Services, Indigenous, Health Knowledge, Attitudes, Practice, Chronic Disease, Medication Adherence, Life Style, Patient Education as Topic, Australia

Abstract

Background: Poor medication management may contribute to the increased morbidity and mortality of Aboriginal people in Australia. Yet while there is extensive literature about the perceptions of healthcare providers on this issue, there is limited information on the perceptions of Aboriginal people themselves.

Objectives: To investigate the perceptions of a group of Aboriginal people attending a Victorian regional Aboriginal Health Service (AHS) with diagnosed medical conditions requiring medications, of their lifestyle, disease management and medication usage.

Methods: Data was collected through one to one in depth interviews using a semi-structured ‘yarning’ process. Twenty patients were invited to participate in the study and were interviewed by Aboriginal Health Workers in a culturally appropriate manner. The interviews were recorded and transcribed verbatim. The data were analysed using descriptive statistics.

Results: Our results show that the majority of participants perceived that changes in lifestyle factors such as diet, exercise, and smoking cessation would help improve their health. Most patients reported having been counselled on their medicines, and while the majority reported adherence and acknowledgement of the efficacy of their medicines, there was a lack of clarity regarding long term maintenance on regimens. Finally, while the majority reported taking over the counter products, some did not see the need to inform their doctor about this, or chose not to.

Conclusion: Chronic illness was perceived as common in families and community. Patients relied mostly on their health care professionals as sources for their drug information. Patients may have benefited from further counselling in the area of complementary and other over the counter medicines, as well as on the necessity of maintenance of regimes for chronic disease management. Finally, lifestyle changes such as dietary improvements and smoking cessation were identified as areas that may assist in improving health outcomes.

Downloads

Download data is not yet available.

Author Biography

Melissa Deacon-Crouch

Melissa Deacon-Crouch

Senior Lecturer,Department of Rural Nursing & Midwifery | La Trobe Rural Health School
College of Science, Health & Engineering | La Trobe University  

References

1. Botfield J, Zwi A, Hill P. Policy context and narrative leading to the commissioning of the Australian indigenous burden of disease study. Health Res Policy Syst. 2015;13:17. doi: 10.1186/s12961-015-0004-0

2. Brown A. Bridging the survival gap between Indigenous and non-Indigenous Australians: priorities for the road ahead. Heart Lung Circ. 2009;18(2):96-100. doi: 10.1016/j.hlc.2009.01.005

3. Gracey M, Burke V, Martin DD, Johnston RJ, Jones T, Davis EA. Assessment of risks of" lifestyle" diseases including cardiovascular disease and type 2 diabetes by anthropometry in remote Australian Aborigines. Asia Pac J Clin Nutr. 2007;16(4):688-697.

4. King M, Smith A, Gracey M. Indigenous health part 2: the underlying causes of the health gap. Lancet. 2009;374(9683):76-85. doi: 10.1016/S0140-6736(09)60827-8

5. Ring IT, Brown N. Indigenous health: chronically inadequate responses to damning statistics. Med J Aust. 2002;177(11-12):629-631.

6. Gracey M, King M. Indigenous health part 1: determinants and disease patterns. Lancet. 2009;374(9683):65-75. doi: 10.1016/S0140-6736(09)60914-4

7. O'Dea K. Westernisation, insulin resistance and diabetes in Australian aborigines. Med J Aust. 1991;155(4):258-264.

8. Spurling G, Hayman NE, Cooney AL. Adult health checks for Indigenous Australians: the first year’s experience from the Inala Indigenous Health Service. Med J Aust. 2009;190(10):562-564.

9. AIHW. Cardiovascular disease, diabetes and chronic kidney disease: Australian facts mortality. no. 1. ed. Canberra; 2014.

10. Closing the Gap Clearinghouse (AIHW, AIFS). What works to overcome Indigenous disadvantage: key learnings and gaps in the evidence. Produced for the Closing the Gap Clearinghouse. Canberra: Australian Institute of Health and Welfare & Melbourne: Australian Institute of Family Studies: Australian Institute of Health and Welfare; 2011.

11. Adams K, Faulkhead S. This is not a guide to Indigenous research partnerships Inform Comm Soc. 2012;15(7):1016-1036. doi: 10.1080/1369118X.2012.709260

12. Bessarab D, Ng'andu B. Yarning about yarning as a legitimate method in indigenous research. Int J Crit Indigenous Stud. 2010;3(1):37-50.

13. Brands J, Brown A, Duffy M, Dunbar T, Franks C, Ragg L, White E, Walton S. Research Partnerships: Yarning about Research with Indigenous Peoples, Workshop Report 1, CRCATH, Darwin. 2002. Available at: http://www.lowitja.org.au/sites/default/files/docs/Research_Partnerships.pdf (accesed August 4, 2016).

14. Brands J, Gooda M. Putting the users of research in the driver's seat: the Cooperative research centre for Aboriginal Health's new approach to research development. Aust Aboriginal Stud. 2006;2:27-35.

15. Cochran PA, Marshall CA, Garcia-Downing C, Kendall E, Cook D, McCubbin L, Gover RM. Indigenous Ways of Knowing: Implications for Participatory Research and Community. Am J Public Health. 2008;98(1):22-27.

16. De Crespigny C, Emden C, Kowanko I, Murray H. A 'partnership model' for ethical indigenous research, v.11, no.4, Oct 2004: 7-13. Collegian (Deakin, ACT). 2004;11:4.

17. Gorman D, Toombs M. Matching Research Methodology with Australian Indigenous Culture. Aboriginal and Islander healthworker J. 2009;33(3):4-7.

18. Holmes W, Stewart P, Garrow A, Anderson I, Thorpe L. Researching Aboriginal health: experience from a study of urban young people’s health and well-being. Soc Sci Med. 2002;54(8):1267-1279.

19. Janke T. Our culture our future : report on Australian indigenous cultural and intellectual property rights / written and researched by Terri Janke ; prepared for Australian Institute of Aboriginal and Torres Strait Islander Studies and the Aboriginal and Torres Strait Islander Commission. Australian Institute of A, Torres Strait Islander S, Australia A, Torres Strait Islander C, editors. Surry Hills, N.S.W: Michael Frankel & Company, Solicitors; 1998.

20. Humphery K, Weeramanthri T, Fritz J. Forgetting Compliance: Aboriginal Health and Medical Culture. Darwin: Northern Territory University Press in association with the Cooperative Research Centre for aboriginal and Tropical Health; 2001.

21. Davidson P, Abbott P, Davison J, DiGiacomo M. Improving medication uptake in aboriginal and Torres Strait islander peoples. Heart Lung Circ. 2010;19(5-6):372-377. doi: 10.1016/j.hlc.2010.01.010

22. Hamrosi K, Taylor SJ, Aslani P. Issues with prescribed medications in Aboriginal communities: Aboriginal Health Workers' perspectives. Rural and Remote Health [Internet]. 2006 2/9/2009; 6:[557 p.]. Available at: http://rrh.deakin.edu.au (accesed August 4, 2016).

23. Larkin C, Murray R. Assisting Aboriginal patients with medication management. Australian Prescribing. 2005;28:123-125.

24. Kelaher M, Dunt D, Taylor-Thomson D, Harrison N, O'Donoghue L, Barnes T, Anderson I. Improving access to medicines among clients of remote area Aboriginal and Torres Strait Islander Health Services. Aust N Z J Public Health. 2006 Apr;30(2):177-183. doi: 10.1111/j.1467-842X.2006.tb00113.x

25. Swain L, Barclay L. They've given me so many tablets, I'm bushed. I don't know where I'm going. Aboriginal and Torres Strait Islander peoples' experiences with medicines. Aust J Rural Health. 2013;21(4):216-219. doi: 10.1111/ajr.12053

26. Pink B, Allbon P. 4704.0–The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples. Canberra (AUST): ABS. 2008.

27. Norman CD, Skinner HA. eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006;8(2):e9.

28. Rawlings D, Tieman J. Patient and carer information: Can they read and understand it?: An example from palliative care. Aust Nurs Midwifery J. 2015;23(5):26-29.

29. Skinner T, Ellis I. Tale of two courthouses: A critique of the underlying assumptions in chronic disease Self-management for Aboriginal people. Australasian Med J. 2009;2(14):239-243. doi 10.4066/AMJ.2009.181

30. McBain‐Rigg KE, Veitch C. Cultural barriers to health care for Aboriginal and Torres Strait Islanders in Mount Isa. Aust J Rural Health. 2011;19(2):70-74. doi: 10.1111/j.1440-1584.2011.01186.x

31. Mackey P, Boxall A, Partel K. The relative effectiveness of Aboriginal Community Controlled Health Services compared with mainstream health service. Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association, 2014 Contract No.: 12.

32. Pettigrew S, Jongenelis MI, Moore S, Pratt IS. A comparison of the effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal Australians. Soc Sci Med. 2015;145:120-124. doi: 10.1016/j.socscimed.2015.09.025

33. Saba M, Diep J, Saini B, Dhippayom T. Meta‐analysis of the effectiveness of smoking cessation interventions in community pharmacy. J Clin Pharm Ther. 2014;39(3):240-247. doi: 10.1111/jcpt.12131

34. Heitjan D, Asch D, Ray R, Rukstalis M, Patterson F, Lerman C. Cost-effectiveness of pharmacogenetic testing to tailor smoking-cessation treatment. Pharmacogenomics J. 2008;8(6):391-389. doi: 10.1038/sj.tpj.6500492

35. Kortmann GL, Dobler CJ, Bizarro L, Bau CH. Pharmacogenetics of smoking cessation therapy. Am J Med Genet B Neuropsychiatr Genet. 2010;153B(1):17-28. doi: 10.1002/ajmg.b.30978

36. Ray R, Tyndale RF, Lerman C. Nicotine dependence pharmacogenetics: role of genetic variation in nicotine-metabolizing enzymes. J Neurogenet. 2009;23(3):252-261. doi: 10.1080/01677060802572887

37. McRae M, Taylor SJ, Swain L, Sheldrake C. Evaluation of a pharmacist-led, medicines education program for Aboriginal Health Workers. Rural Remote Health. 2008;8(4):946.

38. Swain L, Griffits C, Pont L, Barclay L. Attitudes of pharmacists to provision of Home Medicines Review for Indigenous Australians. Int J Clin Pharm. 2014;36(6):1260-1267. doi: 10.1007/s11096-014-0030-y

39. Swain L, Barclay L. Medication reviews are useful, but the model needs to be changed: Perspectives of Aboriginal Health Service health professionals on Home Medicines Reviews. BMC Health Serv Res. 2015;15:366. doi: 10.1186/s12913-015-1029-3

40. Cass A, Lowell A, Christie M, Snelling PL, Flack M, Marrnganyin B, Brown I. Sharing the true stories: improving communication between Aboriginal patients and healthcare workers. Med J Aust. 2002;176(10):466-470.

41. Mackean T, Mokak R, Carmichael A, Phillips GL, Prideaux D, Walters TR. Reform in Australian medical schools: a collaborative approach to realising Indigenous health potential. Med J Aust. 2007;186(10):544-546.

42. Spiers M, Harris M. Challenges to student transition in allied health undergraduate education in the Australian rural and remote context: a synthesis of barriers and enablers. Rural Remote Health. 2015;15(2):3069.
Published
2016-09-29
How to Cite
1.
Deacon-Crouch M, Skinner I, Connelly M, Tucci J. Chronic disease, medications and lifestyle: perceptions from a regional Victorian Aboriginal community. Pharm Pract (Granada) [Internet]. 2016Sep.29 [cited 2019Jun.16];14(3):798. Available from: https://www.pharmacypractice.org/journal/index.php/pp/article/view/798
Section
Original Research