Résumés
Abstract
Francophones are an official language minority in Ontario with limited access to linguistically concordant healthcare services. Although communication is an important skill in the field of pharmacy, little is known about the availability of French-speaking pharmacists. This secondary data analysis of the Ontario College of Pharmacists registry converted weekly hours worked into full-time equivalents (FTEs) and calculated ratios of pharmacist FTEs per 1,000 population. French-speaking pharmacists tended to offer fewer FTEs in communities with a larger concentration of Francophones, particularly in northern and rural areas, a trend that was not observed among English-speaking pharmacists. This maldistribution of French-speaking pharmacists may limit the ability of official language minority patients to receive pharmacy services in their language of choice.
Keywords:
- English,
- pharmacists,
- Francophones,
- linguistic concordance,
- geographic distribution,
- French-language health services
Résumé
Les francophones sont une minorité linguistique en Ontario avec un accès limité aux services de soins de santé en français. Bien que la communication soit une compétence importante dans le domaine de la pharmacie, on en connait peu sur la disponibilité des pharmaciens francophones. Cette analyse de données secondaires du registre de l’Ordre des pharmaciens de l’Ontario a permis de convertir les heures hebdomadaires travaillées en équivalents temps plein (ETP) et de calculer des ratios d’ETP pour 1000 habitants. Les pharmaciens francophones avaient tendance à offrir moins d’ETP dans les communautés à plus forte concentration de francophones, en particulier dans les régions nordiques et rurales, une tendance qui n’a pas été observée chez les pharmaciens anglophones. Cette mauvaise répartition des pharmaciens francophones peut limiter la capacité des patients de langue officielle minoritaire à recevoir des services pharmaceutiques dans la langue de leur choix.
Mots-clés :
- pharmaciens,
- francophones,
- concordance linguistique,
- distribution géographique,
- service de santé en français
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Acknowledgements
We thank the Ontario College of Pharmacists for entering into an agreement to share their data with us. Funding for this study was provided by the Consortium National de Formation en Santé (CNFS) – Volet Université Laurentienne and Volet Collège Boréal, as well as the Government of Ontario, Ontario Ministry of Health and Long-Term Care (MOHLTC, ministry grant no. 6674).
Bibliography
- Arora, D. S., Mey, A., Maganlal, S., & Khan, S. (2015). Provision of pharmaceutical care in patients with limited English proficiency: Preliminary findings. Journal of Research in Pharmacy Practice,4(3), 123-128. https://www.jrpp.net/text.asp?2015/4/3/123/162358
- Association of Faculties of Medicine of Canada. (n.d.). The Development of French speaking medical human resources in Francophone minority communities in Canada. https://www.afmc.ca/en/learners/franco-doc
- Australian Government Department of Health. (n.d.). Community Pharmacy Programs.https://www1.health.gov.au/internet/main/publishing.nsf/Content/community-pharmacy- programs#RuralSupportprograms
- Bailey, S. C., Pandit, A. U., Curtis, L., & Wolf, M. S. (2009). Availability of Spanish prescription labels: A multi-state pharmacy survey. Medical care, 47(6), 707-710. http://www.jstor.org/stable/40221941
- Batal, M., Makvandi, E., Imbeault, P., Gagnon-Arpin, I., Grenier, J., Chomienne, M.-H., & Bouchard, L. (2013). Comparison of dietary intake between Francophones and Anglophones in Canada: Data from CCHS 2.2. Canadian Journal of Public Health,104(6), S31-S38. https://doi.org/10.17269/cjph.104.3501
- Bates, D. W., Spell, N., Cullen, D. J., Burdick, E., Laird, N., Petersen, L. A., Small, S. D., Sweitzer, B. J., & Leape, L. L. (1997). The costs of adverse drug events in hospitalized patients. JAMA,277(4), 307-311. https://jamanetwork.com/journals/jama/article-abstract/413545
- Bensing, J. (1991). Doctor-patient communication and the quality of care. Social Science & Medicine,32(11), 1301-1310. https://doi.org/10.1016/0277-9536(91)90047-G
- Bouchard, L., Batal, M., Imbeault, P., Gagnon-Arpin, I., Makandi, E., & Sedigh, G. (2012). La santé des Francophones de l’Ontario : un portrait régional tiré des Enquêtes sur la santé dans les collectivités canadiennes (ESCC). Report prepared for the Réseau de recherche appliquée sur la santé des francophones de l’Ontario, Ottawa, ON.
- Bouchard, L., Beaulieu, M., & Desmeules, M. (2012). L’offre active de services de santé en français en Ontario : une mesure d’équité. Reflets : revue d’intervention sociale et communautaire, 18(2), 38-65. https://doi.org/10.7202/1013173ar
- Bouchard, L., & Desmeules, M. (2013). Les minorités linguistiques du Canada et la santé. Healthcare Policy, 9(Special Issue), 38-47. https://savoir-sante.ca/fr/content_page/download/281/455/21?method=view
- Bowen, S. (2001). Language barriers in access to health care. Ottawa: Health Canada.
- Canadian Pharmacists Association. (2020). Pharmacists’ scope of practice in Canada. https://www.pharmacists.ca/pharmacy-in-canada/scope-of-practice-canada/
- Cipolle R. J., Strand, L. M., & Morley, P. C. (1998) Pharmaceutical car practice. McGraw-Hill.
- Cohen, A. L., Rivara, F., Marcuse, E. K., McPhillips, H., & Davis, R. (2005). Are language barriers associated with serious medical events in hospitalized pediatric patients? Pediatrics, 116(3), 575-579. https://doi.org/10.1542/peds.2005-0521
- de Moissac, D., & Bowen, S. (2019). Impact of language barriers on quality of care and patient safety for official language minority Francophones in Canada. Journal of Patient Experience, 6(1), 24-32. https://doi.org/10.1177%2F2374373518769008
- Desmeules, M., Pong, R., Lagacé, C., Heng, D., Manuel, D., Pitblado, R., Bollman, R., Guernsey, J., Kazanjian, A., & Koren, I. (2006). How healthy are rural Canadians? An assessment of their health status and health determinants. Ottawa: Canadian Institute for Health Information.
- Dilworth, T. J., Mott, D., & Young, H. (2009). Pharmacists’ communication with Spanish-speaking patients: A review of the literature to establish an agenda for future research. Research in Social and Administrative Pharmacy, 5(2), 108-120. https://doi.org/10.1016/j.sapharm.2008.05.005
- Divi, C., Koss, R. G., Schmaltz, S. P., & Loeb, J. M. (2007). Language proficiency and adverse events in US hospitals: A pilot study. International Journal for Quality in Health Care,19(2), 60-67. https://doi.org/10.1093/intqhc/mzl069
- Donabedian, A. (1988). The quality of care: How can it be assessed?. JAMA,260(12), 1743-1748. https://jamanetwork.com/journals/jama/article-abstract/374139
- Fédération des communautés francophones et acadienne du Canada (FCFA). (2001). Improving access to French-language health services. https://fcfa.ca/wp-content/uploads/2018/03/Pour-un-meilleur-acces-a-des-services-de-sante-en-francais-EN.pdf
- Feldman-Stewart, D., Brundage, M. D., & Tishelman, C. (2005). A conceptual framework for patient-professional communication: An application to the cancer context. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer,14(10), 801-809. https://doi.org/10.1002/pon.950
- French Language Health Planning Entities and French Language Health Networks of Ontario. (2015). Joint position statement on the active offer of French language health services in Ontario. https://www.rssfe.on.ca/upload-ck/EnoncE_OffreActive_10mars15_ANG.pdf
- Gagnon-Arpin, I., Makvandi, E., Imbeault, P., Batal, M., & Bouchard, L. (2013). Le surplus de poids chez les francophones et les anglophones. Canadian Journal of Public Health/Revue Canadienne de Santé Publique. 104(6), S21-S25. https://www.jstor.org/stable/canajpublheal.104.6.0s21
- Gauthier, A. P., Timony, P. E., Serresse, S., Goodale, N., & Prpic, J. (2015). Strategies for improved French-language health services: Perspectives of family physicians in northeastern Ontario. Canadian Family Physician,61(8), e382-e390. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541448
- Gauthier, A. P., Timony, P. E., & Wenghofer, E. F. (2012). Examining the geographic distribution of French-speaking physicians in Ontario. Canadian Family Physician, 58(12), e717-e724. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520679/
- Gregg, J., & Saha, S. (2007). Communicative competence: A framework for understanding language barriers in health care. Journal of General Internal Medicine, 22, 368-370. https://doi.org/10.1007/s11606-007-0364-4
- Hargie, O. D., Morrow, N. C., & Woodman, C. (2000). Pharmacists’ evaluation of key communication skills in practice. Patient Education and Counseling,39(1), 61-70. https://doi.org/10.1016/S0738-3991(99)00091-9
- Hayhoe, B., Cespedes, J. A., Foley, K., Majeed, A., Ruzangi, J., & Greenfield, G. (2019). Impact of integrating pharmacists into primary care teams on health systems indicators: A systematic review. British Journal of General Practice,69(687), e665-e674. https://doi.org/10.3399/bjgp19X705461
- Hays, C. A., Taylor, S. M., & Glass, B. D. (2020). The rural pharmacy practice landscape: Challenges and motivators. Journal of Multidisciplinary Healthcare,13, 227-234. https://doi.org/10.2147/JMDH.S236488
- Hogenbirk, J. C., Timony, P. E., French, M. G., Strasser, R., Pong, R. W., Cervin, C., & Graves, L. (2016). Milestones on the social accountability journey: Family medicine practice locations of Northern Ontario School of Medicine graduates. Canadian Family Physician, 62(3), e138-e145. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984600/
- Imbeault, P., Makvandi, E., Batal, M., Gagnon-Arpin, I., Grenier, J., Chomienne, M.-H, & Bouchard, L. (2013). Physical inactivity among Francophones and Anglophones in Canada. Canadian Journal of Public Health, 10(46), S26-S30. https://doi.org/10.17269/cjph.104.3467
- Jacobs, E., Chen, A. H., Karliner, L. S., Agger-Gupta, N., & Mutha, S. (2006). The need for more research on language barriers in health care: A proposed research agenda. The Milbank Quarterly,84(1), 111-133. https://doi.org/10.1111/j.1468-0009.2006.00440.x
- Jutras, C., Gauthier, A. P., Timony, P. E., Côté, D., & Kpazaï, G. (2020). Expérience de francophones en Ontario chez leur médecin de famille : concordance et discordance linguistique. Diversity of Research in Health Journal/La Revue de la Diversité de la Recherche en Santé,3, 12-33. https://doi.org/10.28984/drhj.v3i0.310
- Logothetis, P. (2021, June 3). uOttawa creates a new School of Pharmaceutical Sciences with first ever French pharmacy program outside Quebec. University of Ottawa. https://med.uottawa.ca/en/news/uottawa-creates-new-school-pharmaceutical-sciences-first-ever-french-pharmacy-program
- Ministry of Francophone Affaires. (2019). Profile of the Francophone population in Ontario – 2016. https://www.ontario.ca/page/profile-francophone-population-ontario-2016#:~:text=Ontario%20has%20622%2C415%20Francophones%2C%20according%20to%20the%202016%20Census%20data.&text=The%20Francophone%20population%20has%20increased,(%2D0.1%25)%20since%202011
- National Assembly for Wales Health and Social Care Committee. (2012). The contribution of community pharmacy to health services in Wales. National Assembly for Wales Commission. https://business.senedd.wales/documents/s7883/The%20contribution%20of%20community%20pharmacy%20to%20health%20services%20in%20Wales%20-%20Report%20-%20May%202012.pdf
- National Association of Pharmacy Regulatory Authorities. (2009). Model standards of practice for Canadian pharmacists. https://nbcp.in1touch.org/document/6852/GM-PP-SP-01-NAPRA’s%20Model%20Standards%20of%20Practice%20for%20Canadian%20Pharmacists.pdf
- Ngo-Metzger, Q., Sorkin, D. H., Phillips, R. S., Greenfield, S., Massagli, M. P., Clarridge, B., & H. Kaplan, S. H. (2007). Providing high-quality care for limited English proficient patients: The importance of language concordance and interpreter use. Journal of General Internal Medicine,22(2, Suppl.), 324-330.
- Niznik, J. D., He, H., & Kane-Gill, S. L. (2018). Impact of clinical pharmacist services delivered via telemedicine in the outpatient or ambulatory care setting: A systematic review. Research in Social and Administrative Pharmacy, 14(8), 707-717. https://doi.org/10.1016/j.sapharm.2017.10.011
- Obamiro, K. O., Tesfaye, W. H., & Barnett, T. (2020). Strategies to increase the pharmacist workforce in rural and remote Australia: A scoping review. Rural and Remote Health, 20(4). https://doi.org/10.22605/RRH5741
- Office of Francophone Affairs. (2014). Agency designation plan and evaluation tool. https://drive.google.com/file/d/17QyLgB0l2Q7E-9jQLelM1yae-TDM4lTZ/view
- Office of the French Language Services Commissioner. (2009). Special report on French language health services planning in Ontario. https://csfontario.ca/wp-content/uploads/2009/05/FLSC_report_french_health_planning_2009.pdf
- Office of the French Language Services Commissioner. (2016). Annual report 2015-2016: FLSA 2.0. https://csfontario.ca/en/rapports/ra1516
- Ong, L. M., de Haes, J. C., Hoos, A. M., & Lammes, F. B. (1995). Doctor-patient communication: A review of the literature. Social Science & Medicine, 40(7), 903-918. https://doi.org/10.1016/0277-9536(94)00155-M
- Pampalon, R., Martinez, J., & Hamel, D. (2006). Does living in rural areas make a difference for health in Quebec? Health & Place,12(4), 421-435. https://doi.org/10.1016/j.healthplace.2005.04.002
- Picard, L., & Allaire, G. (2005). Second report on the health of Francophones in Ontario. Public Health Research, Education & Development Program, Sudbury and District Health Unit and Institut franco-ontarien. http://institutfranco-ontarien.ca/wp-content/uploads/2019/05/rapport_sante_jan06.pdf
- Pong, R. W. (2008). Strategies to overcome physician shortages in northern Ontario: A study of policy implementation over 35 years. Human Resources for Health,6(1), 24. https://doi.org/10.1186/1478-4491-6-24
- Pong, R. W., Desmeules, M., & Lagacé, C. (2009). Rural-urban disparities in health: How does Canada fare and how does Canada compare with Australia? The Australian Journal of Rural Health,17(1), 58-64. https://doi.org/10.1111/j.1440-1584.2008.01039.x
- Praska, J. L., Kripalani, S., Seright, A. L., & Jacobson, T. A. (2005). Identifying and assisting low-literacy patients with medication use: A survey of community pharmacies. Annals of Pharmacotherapy,39(9), 1441-1445. https://doi.org/10.1345/aph.1G094
- Siganga, W. W., & Huynh, T. C. (1997). Barriers to the use of pharmacy services: The case of ethnic populations: By understanding cultural and other factors that affect the health of ethnic patients, pharmacists can take appropriate steps to improve care. Journal of the American Pharmaceutical Association,37(3), 335-340. https://doi.org/10.1016/S1086-5802(16)30207-8
- Statistics Canada. (2016). Mother Tongue, First Official Language Spoken, Language Spoken Most Often at Home, Other Language(s) Spoken Regularly at Home, Age and Sex for the Population Excluding Institutional Residents of Canada, Provinces and Territories, Census Metropolitan Areas and Census Agglomerations, 2016 Census, (Catalogue no. 98-400-X2016345). Retrieved March 18, 2022 from Statistics Canada: https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.cfm?TABID=2&Lang=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=1235625&GK=0&GRP=1&PID=109661&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2016&THEME=118&VID=0&VNAMEE=&VNAMEF=&D1=0&D2=0&D3=0&D4=0&D5=0&D6=0
- Stewart, M. A (1995). Effective physician-patient communication and health outcomes: A review. CMAJ: Canadian Medical Association Journal, 152(9), 1423-1433.
- Strasser, R., Hogenbirk, J. C., Minore, B., Marsh, D. C., Berry, S., Mccready, W. G., & Graves, L. (2013). Transforming health professional education through social accountability: Canada’s Northern Ontario School of Medicine. Medical Teacher,35(6), 490-496. https://doi.org/10.3109/0142159X.2013.774334
- Timony, P., Gauthier, A., Hogenbirk, J. C., & Wenghofer, E (2013). Promising quantities, disappointing distribution. Investigating the presence of French-speaking physicians in Ontario’s rural Francophone communities. Rural and Remote Health, 13(4). www.rrh.org.au/journal/article/2543
- Timony, P., Gauthier, A., Serresse, S., Goodale, N., & Prpic, J. (2016). Barriers to offering French language physician services in rural and northern Ontario. Rural and Remote Health, 16(2). www.rrh.org.au/journal/article/3805
- Ulrich, E., Hurdelbrink, J., Perepelkin, J., & Welter, K. (2019). Financial incentive required for pharmacy students to accept a post-graduation position in rural and undesirable pharmacy settings. Pharmacy,7(3), 109. https://doi.org/10.3390/pharmacy7030109
- Wenghofer, E., Timony, P., & Pong, R. (2011). “A closer look at Ontario’s northern and southern rural physician demographics. Rural and Remote Health, 11(1). www.rrh.org.au/journal/article/1591
- Wilson, E., Chen, A. H., Grumbach, K., Wang, F., & Fernandez, A. (2005). Effects of limited English proficiency and physician language on health care comprehension. Journal of General Internal Medicine, 20(9), 800-806. https://doi.org/10.1111/j.1525-1497.2005.0174.x
- French Language Services Act, R.S.O. 1990, chapter F.32 (1990). https://www.ontario.ca/laws/statute/90f32
- Pharmacy Act, 1991, S.O. 1991, c. 36.
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