“They not only value a patient but a person”: exploring the views of Samoan, Tongan and Niuean people receiving heart healthcare and families, on the role of community pharmacists

Abstract

Background: In Aotearoa New Zealand, cardiovascular disease (CVD) is the leading cause of differences in life expectancy between Pacific and non-Māori non-Pacific people. Pharmacists have expertise in medicine management and are often described as one of the most accessible healthcare providers. However, their role in supporting equity in heart health outcomes is not well explored.

Objectives: This research explored the experiences and perspectives of Pacific people and families living with CVD regarding how community pharmacists did and could support them to manage their CVD, as well as their ideas for improving this support.

Methods: Interpretive description framed this research. Ethnic-specific focus groups and individual interviews with Samoan, Tongan and Niuean people and their families were used to generate data. Template analysis was used to generate themes.

Results: Three focus groups and seven interviews were conducted with 14 Samoan, 10 Tongan and 11 Niuean participants. Overall, participants found pharmacists to be supportive of their heart health through the provision of in-depth explanations of medications and safety and opportunities to ask questions. Five overarching themes arose from the data analysis: i) relationships and roles in the healthcare system, ii) cultural congruence, iii) facilitating an accessible system, iv) expectations of a complex and disconnected healthcare system on service users, and v) a negligent and exploitative healthcare system. Suggestions for service improvement included more accessible knowledge that was easy to navigate and translate.

Conclusion: Most of the participants reported having a positive therapeutic relationship with their community pharmacist. These relationships supported and improved people’s access to a healthcare system that could at times be culturally unsafe and place unrealistic expectations on the knowledge that service users have about heart healthcare. The system was also perceived as exploiting power imbalances and Pacific values to provide sub-optimal services that failed to meet the needs of Pacific peoples.