Social Context of Patients³

Control over environment

• How do you usually pay for your medication? Are you ever short of food or clothing?
• How do you keep track of appointments? Are you more concerned about how your health affects you right now or how it might affect you in the future?

Change in environment

• Where are you from?
• What made you decide to come to this country [city, town]? When did you come?
• How have you found life here compared to life in your country [city, town]?
• What was medical care like there, compared with here? How did you get your medication?

Social stressors and support network

• What is causing the most difficulty or stress in your life? How do you deal with this?
• Do you have friends or relatives that you can call on for help? Who are they? Do they live close to you?
• Are you very involved in a religious or social group? Do you feel that God [or a higher power] provides a strong source of support in your life?

Literacy and language

• Do you have trouble reading your medication bottles or appointment slips?
• What language do you speak at home? Do you ever feel that you have a hard time talking about your medicine with the doctor or pharmacist?

Negotiating Across Cultures for Management Options^{3, 4}

1. Describe specific medication information in easy-to-understand words
2. Prioritize medication management options
3. Determine patient’s priorities
4. Present a reasonable medication management plan that reflects both patient and pharmacist priorities
5. Ask patient directly about their level of acceptance of this plan
6. If conflict remains, focus negotiation on highest priorities