Cultural influences on medicine use among first-generation Pakistani immigrants in Norway

The aim of this study was to explore medicine use among first-generation immigrants from Pakistan who had been residing in Norway 10 years or more, with emphasis on cultural influences, language proficiency, and sociodemographic variables. Personal interviews with 82 first-generation Pakistani immigrants (40-80 years) were conducted primarily in the participant's home using a semistructured questionnaire. The participants were users of antihypertensives, and/or antidiabetics, and/or cholesterol-lowering drugs. All participants had a family doctor in Norway. They used on average 6.7 (range: 1-28) prescription drugs, and 48% used nonprescription drugs (primarily analgesics) as well. Fifteen percent were occasionally using drugs acquired from Pakistan. Two thirds reported various disease symptoms despite being on medication. Fifty-one percent lacked essential knowledge of their drug therapy, but 93% were of the opinion that it was important to take drugs every day. Nearly half of the participants altered their drug taking during Ramadan. Women were overrepresented when it came to reporting symptoms, fasting, frequent physician visits, and communicational challenges in the pharmacies. Women and/or those with low educational levels were most likely to send someone else to collect their drugs from the pharmacy or bring family members along to act as translators. This study shows that cultural influences may affect medicine use among first-generation immigrants from Pakistan after having lived 10 years or more in Norway. Although access to drugs and basic health care services seems to be problem free, language proficiency is a considerable problem that obstructs access to information and is detrimental to the level of communication with health professionals.