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Exploring risk assessment tools for medicine-related problems among culturally and linguistically diverse patients in
Rawan Sawalha1,2, Sarah Al-Samawy3, Zeyad Mahmoud4
1School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia. Rawan.sawalha@uon.edu.au.
Purpose:
This review evaluated publications that described medicine risk assessment tools developed or adapted for use in Australia to assess risks associated with medicine-related problems (MRPs). It examined whether these tools considered cultural background as a crucial risk factor for MRPs and whether clinical guidelines provided tailored recommendations for Culturally and Linguistically Diverse (CALD) patients.
Methods:
A systematic search was conducted in Web of Science, Scopus, CINHAL, EMBASE, PubMed/Medline and Google Scholar (January 1985-November 2024). The review included publications on the development or validation of medicine risk assessment tools for MRPs in Australia, as well as clinical guidelines relevant to managing diseases classified as National Health Priority Areas (NHPAs).
Results:
Sixteen publications on thirteen medication risk assessment tools and thirteen publications on twelve clinical therapeutic guidelines were included. Risk factors varied widely and were categorised into four groups: patient-related (e.g. age, cognitive status), disease-related (e.g. comorbidities), medicine-related (e.g. polypharmacy), and health services-related (e.g. re-hospitalisations). Only one tool considered CALD background as a risk factor for MRPs. Although some tools acknowledged non-adherence or communication issues, they did not systematically address underlying cultural or linguistic factors. Clinical guidelines primarily focused on self-management and providing information in CALD patients' first language, with some encouraging interpreter use.
Conclusion:
Medicine risk assessment tools lack consistent frameworks, and CALD backgrounds are largely overlooked as a key demonstrated risk factor for MRPs. Future research should develop inclusive tools and clinical guidelines incorporating cultural and linguistic factors. Policymakers and healthcare practitioners should refine these tools to improve medication safety and achieve equitable healthcare outcomes for CALD populations.
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