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英国少数民族、亚裔和黑人老年人群中的药物管理:一项混合研究系统评价。

Medication management in Minority, Asian and Black ethnic older people in the United Kingdom: A mixed-studies systematic review.

机构信息

Pharmacy Department, Kent and Medway NHS and Social Care Partnership Trust, Maidstone, UK.

Evidence Synthesis, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.

出版信息

J Clin Pharm Ther. 2022 Sep;47(9):1322-1336. doi: 10.1111/jcpt.13735. Epub 2022 Jul 18.

Abstract

WHAT IS NEW AND OBJECTIVES

Older people from ethnic minorities experience the intersectionality of age and ethnicity in relation to complex medication management and polypharmacy. Minority ethnic groups in the United Kingdom are at risk of poor medication management because factors such as cultural beliefs, language barriers, lack of knowledge of how the healthcare system works may affect their ability to safely manage their medications. The aim of this systematic review was to review the literature focussing on medication management in the older population amongst ethnic minority communities in United Kingdom.

METHODS

The review was conducted and reported according to methods in the Cochrane Handbook and in the PRISMA 2020 statement using databases such as EMBASE, ASSIA, MEDLINE, PsychINFO and others. Studies conducted in the United Kingdom on individuals over 60 years of age and from a minority ethnic background were included. A thematic analysis was used to synthesize the results.

RESULTS AND DISCUSSION

Nine studies (eight from initial searches, one from a search update in 2021) met the inclusion criteria. Three main themes were identified: misbeliefs around medications, poor health literacy, communication and education as possible intervention to improve medication management. Misbeliefs around long-term illnesses exert a negative impact on medication management. Poor health literacy around medications influences patients' adherence to treatments. Poor communication is perceived as barrier to successful medication management. Despite extensive searching, the team identified a limited number of studies and a lack of intersectional studies focussing on minority ethnic groups and the older population.

WHAT IS NEW AND CONCLUSION

Our findings suggest tailored education as a possible intervention to improve medication management amongst these minority groups. Future research should look at recruiting participants from specific ethnic groups and from rural as well as urban areas to explore how medication management operates in different areas of the United Kingdom.

摘要

新内容和目的

少数民族老年人在与复杂的药物管理和多药治疗相关的方面经历了年龄和族裔的交叉。英国的少数族裔群体面临着药物管理不善的风险,因为文化信仰、语言障碍、缺乏对医疗保健系统运作方式的了解等因素可能会影响他们安全管理药物的能力。本系统评价的目的是综述英国少数民族社区中老年人药物管理的文献。

方法

该评价根据 Cochrane 手册和 PRISMA 2020 声明中的方法进行,并使用 EMBASE、ASSIA、MEDLINE、PsychINFO 等数据库进行检索。纳入了在英国进行的、针对 60 岁以上和少数民族背景个体的研究。使用主题分析对结果进行综合。

结果与讨论

有 9 项研究(8 项来自最初的检索,1 项来自 2021 年的检索更新)符合纳入标准。确定了三个主要主题:对药物的误解、健康素养差、沟通和教育作为改善药物管理的可能干预措施。对长期疾病的误解对药物管理产生负面影响。对药物的健康素养差影响患者对治疗的依从性。沟通不畅被认为是成功药物管理的障碍。尽管进行了广泛的检索,研究小组发现研究数量有限,也缺乏关注少数民族群体和老年人群体的交叉研究。

新内容和结论

我们的研究结果表明,有针对性的教育可能是改善这些少数群体药物管理的一种干预措施。未来的研究应该招募来自特定族裔群体以及来自农村和城市地区的参与者,以探讨药物管理在英国不同地区的运作方式。

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