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Rapid Responses: Rapid Responses published:
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Rising to the challenge
- Wasim Hanif, Dr Vinod Patel, Dr Jiten Vora, Dr Kiran Patel, Dr Paramjit Gill (13 May 2005)
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Rising to the challenge
- Wasim Hanif, Vinod Patel, Jiten Vora, Paramjit Gill, Kiran Patel (14 May 2005)
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Another Erroneous Perception
- Kirti Kain, Andrew J Catto (17 May 2005)
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Wasim Hanif, Diabetes Working Group South Asian Health Foundation, Dr Vinod Patel, Dr Jiten Vora, Dr Kiran Patel, Dr Paramjit Gill
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We congratulate the authors for highlighting the challenge of medication in ethnic populations. Methodologiclly this study follows the well established principles of qualitative research and hence there is no need for large numbers of patients or a control group. There is further clarification of the validation process but the findings do suggest that there is more similarity between these subjects and other ethnic groups in terms of medicine taking. For example Afro-caribbean hypertensives have been shown to be reluctant to take their medication when feeling well and have also perceived medication as being too powerful. This study is in line with current literature and would suggest that western medicine is perceived as being powerful due to the limitations of indigenous therapies. It may not be helpful to focus on cultural issues, such as whether or not people are more likely to take drugs prescribed by British doctors rather than doctors in South Asia, but it may be far more appropriate to see how the challenge (of helping Asians use medicines better) is different/similar to the general population. We suspect the challenges are the same regardless of ethnicity. We encourage not only better interpreting services to enable professionals to communicate with their patients about chronic conditions, but also encourage reporting of such findings in ethnic populations as these authors have done. Competing interests: None declared |
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Wasim Hanif, Diabetes Working Group South Asian Health Foundation, Vinod Patel, Jiten Vora, Paramjit Gill, Kiran Patel
Send response to journal:
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We congratulate the authors for highlighting the challenge of medication in ethnic populations. Methodologically this study follows the well established principles of qualitative research and hence there is no need for large numbers of patients or a control group. There is further clarification of the validation process but the findings do suggest that there is more similarity between these subjects and other ethnic groups in terms of medicine taking. For example Afro-caribbean hypertensives have been shown to be reluctant to take their medication when feeling well1,2 and have also perceived medication as being too powerful. This study is in line with current literature and would suggest that western medicine is perceived as being powerful due to the limitations of indigenous therapies. It may not be helpful to focus on cultural issues, such as whether or not people are more likely to take drugs prescribed by British doctors rather than doctors in South Asia, but it may be far more appropriate to see how the challenge (of helping Asians use medicines better) is different/similar to the general population. We suspect the challenges are the same regardless of ethnicity. We encourage not only better interpreting services to enable professionals to communicate with their patients about chronic conditions, but also encourage reporting of such findings in ethnic populations as these authors have done. 1. Morgan M, Watkins CJ. Managing hypertension: belief and responses to medication among cultural groups. Sociol Health Illness 1988; 10: 561- 578 2. Horne R, Graupner L, Frost S, et al. Medicine in a multi-cultural society: the effect of cultural background on beliefs about medications. SOC SCI MED 2004; 59 (6): 1307-1313. Dr Wasim Hanif Dr Vinod Patel Dr Jiten Vora Dr Paramjit Gill Dr Kiran Patel On behalf of the South Asian Health Foundation Working Group on Diabetes Competing interests: None declared |
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Kirti Kain, Senior Lecturer Academic Unit of Molecular Vascular Medicine, Level 7, The LIGHT laboratories, Leeds, LS2 9JT, Andrew J Catto
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We read with interest the article by Julia Lawton and colleagues in which they describe patients' perceptions of the oral hypoglycaemic agents 1 . We have observed another phenomenon quite frequently among patients. When treatment is started in asymptomatic patients with high blood pressure or high plasma glucose picked up on screening the general population, the patients have the misconception that the treatment is necessary only to bring the blood pressure or the plasma glucose within the normal range. When the review is done they state that they have stopped the treatment because they were told that blood pressure or the plasma glucose was normal the previous time. We find ourselves repeating the message that the blood pressure, blood glucose or the HBA1C is within the normal range because of the treatment hence if they stop the medications the variables will go up again. We have observed this phenomenon more in South Asians as compared to Whites. Though we concur that there are cultural differences nevertheless, we agree wholeheartedly with Professor Trisha Greenhalgh that we should pay more emphasis on educating the patient in preference to focussing on cultural differences 2. As a health professional we are learning throughout our lives and we should give a fair chance to a patient to learn about their chronic illness and help should be provided by all the health care professionals involved preferably in the patient’s mother tongue. With the exception of a few, most patients are very keen to learn about themselves and their illnesses irrespective of their literacy. Dr K Kain
Dr A J Catto
Academic Unit of Molecular Vascular Medicine Level 7, The LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, LS2 9JT 1. Lawton J, Ahmad N, Hallowell N, Hanna L, Douglas M. Perceptions and experiences of taking oral hypoglycaemic agents among people of Pakistani and Indian origin: qualitative study. BMJ 2005. 2. Greenhalgh T. Commentary: Barriers to concordance with antidiabetic drugs--cultural differences or human nature? BMJ 2005. Competing interests: None declared |
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