Achieving equitable health outcomes for Pacific peoples living with cardiovascular disease in Aotearoa New Zealand: exploring the contribution of community pharmacists
Background: In Aotearoa New Zealand, Pacific peoples experience significant inequities in cardiovascular disease (CVD). Community pharmacists are uniquely positioned in the healthcare system, yet there is limited published information regarding their role in Pacific CVD equity. Aim: This research investigated how community pharmacists support the achievement of equitable health outcomes for Pacific peoples living with CVD by exploring the perspectives of Pacific service users, family members, community pharmacists and general practitioners (GPs). Methods: A scoping review was conducted to examine literature on the acceptability and effectiveness of pharmacist-led services tailored for minoritised populations. Pacific principles and interpretive description ensured that this research amplified and upheld the worldviews of the service users and families and acknowledged the healthcare professionals’ views. Co-facilitated Samoan, Tongan and Niuean focus groups were conducted. Semi-structured interviews were conducted with three Samoan, two Tongan and two Niuean individuals, twelve community pharmacists and nine GPs. Findings: The scoping review demonstrated limited literature on pharmacist-led services tailored for minoritised populations. There was no published literature on Pacific-focused CVD services delivered by community pharmacists in Aotearoa. Pacific service users and family members emphasised the critical role of relationships with community pharmacists, highlighting trust and cultural congruence as essential to facilitating medication adherence and healthcare engagement. Challenges identified included language barriers and inequitable healthcare structures. Community pharmacists acknowledged their role as medicine experts and connectors but cited constraints to delivering equitable care for Pacific peoples, such as limited funding and fragmented systems. GPs recognised community pharmacists’ potential to alleviate CVD inequities for Pacific peoples but identified barriers to collaboration between GPs and community pharmacists, including resource constraints and (mis)perceptions. Across all stakeholder groups, the importance of cultural safety, increased Pacific workforce representation, and the need for systemic reform were frequently mentioned. Conclusion: These findings highlight the importance of relationships and systemic challenges in achieving Pacific CVD equity. Increasing Pacific representation, embedding cultural safety training, expanding community pharmacists’ role and fostering inter-professional collaboration are essential to addressing these inequities. These findings can support achieving the goals of Te Mana Ola and ultimately, the broader goal of attaining health equity in Aotearoa.
Networked Digital Library of Theses and Dissertations