Hospital pharmacists, Aboriginal and Torres Strait Islander Peoples and chronic disease: helping to close the gap

Abstract

Aboriginal and Torres Strait Islander Peoples are resilient, have survived and have actively prospered and cared for their communities for millennia. However, as a result of the ongoing effects of colonisation, Aboriginal and Torres Strait Islander Peoples are disproportionately affected by chronic diseases in Australia.

This thesis focussed on diabetes because for Aboriginal and Torres Strait Islander Peoples, diabetes is (1) often experienced from a young age; (2) associated with stigma and shame; (3) screened for using a readily accessible test (HbA1c); (4) has devastating complications which can be prevented by early screening and treatment options.

Diabetes like other chronic diseases causes preventable admissions to hospital for Aboriginal and Torres Strait Islander Peoples. It follows that hospital pharmacists have an opportunity to contribute to improve health outcomes for and together with Aboriginal and Torres Strait Islander Peoples. Review of the literature and a survey of hospital pharmacy departments nationally, did not illustrate extensive work in this area.

By working together with and listening to the priorities of Aboriginal and Torres Strait Islander Peoples, a new model of care was developed, implemented and evaluated. This was a novel pharmacist-led service that offered Aboriginal and Torres Strait Islander Peoples diabetes risk assessment and referral for specialist review, during their hospital stay. This service could help address identified missed opportunities to provide holistic hospital care.

This thesis produced a body of work to illustrate the importance of taking time to work together with Aboriginal and Torres Strait Islander Peoples to improve health outcomes. In doing this, factors required for wider application of such culturally safe models and future projects were identified. This thesis illustrated that success can only be achieved by ongoing collaborative partnerships together with Aboriginal and Torres Strait Islander Peoples.