Developing a model to support safe medication use in the home for foreign-born-persons with language difficulties: a...

Migration has increased population diversity and created challenges for safe medication use. Evidence remains limited regarding factors influencing medication-related problems among migrants and the support needed to optimise medication use in the home. No studies have addressed support for medication use in the home among migrants or proposed models for such support. The aim was to identify the support needed and to develop a model for support to promote safe medication use in the home and prevent medication errors among foreign-born persons with language difficulties.

A co-creation participatory action research design involved end-users-foreign-born persons and relatives, and staff in healthcare and pharmacies. Focus group discussions, based on previous studies, were analysed using qualitative content analysis and interpreted through Pawson's framework across four contextual dimensions: individual, interpersonal, institutional, and infrastructural.

The analysis identified seven areas where support was required: routines to support safe medication use; continuity and risk assessment; support for language understanding; resources; information for patients and relatives to understand medication treatment and the prescribing system; staff training; and national measures. Support was needed across all contexts, particularly at the institutional and infrastructural levels through organisational development and clearer guidelines and regulations, but also at the interpersonal level in everyday interactions with healthcare and pharmacy staff. The findings informed the development of a support model anchored in primary healthcare includingan extended interdisciplinary team involving relatives and pharmacists, coordinated by an accessible contact person.

In conclusion, promoting safe medication use in the home for foreign-born persons with limited language proficiency requires placing a well-informed patient at the centre of care; care planning based on individual needs; and coordinated support across individual, interpersonal, institutional, and infrastructural levels. Everyday practice should be critically reviewed to organise teamwork, allow time for risk assessment, and improve patient and relative education. Strengthening continuity, communication, and shared responsibility across a seamless healthcare chain may reduce medication-related risks and support patients and relatives in managing medications safely in the home. Implementation of the developed model should be accompanied by organisational and policy-level changes to enable sustainable, person-centred medication safety.