Otago study finds Māori miss out on medicines

University of Otago researchers at the School of Pharmacy have found that rural Māori are much less likely to receive antibiotics in spite of the fact that they need them more due to far higher rates of rheumatic fever.

Rheumatic fever starts with a sore throat, but can go on to cause permanent heart damage.

Māori in TeTairawhiti, where the study was carried out, have extremely high rates of rheumatic fever. Heart damage can be prevented in people from high risk groups by taking antibiotics for sore throats.

A research group, led by Professor Pauline Norris and Dr Simon Horsburgh from the School of Pharmacy, obtained information on all medicines dispensed in Te Tairawhiti for a year. They matched this with information on patient age, gender, ethnicity and whether they lived in a rural area.

Over a year, 51% of the population received a prescription for one or more antibiotic. Māori were less likely to receive a prescription (48% of the population) than non-Māori (55%), and received smaller quantities on average. Rural Māori in particular received fewer prescriptions. Among children six years or under, only 43% of rural Maori children received antibiotics during the year, whereas 68% of rural non-Maori, and over 80% of urban children, did receive them.

“Lower levels of antibiotic use could be the result of Māori not visiting the doctor as often, being prescribed antibiotics less frequently when they do visit, or not having their prescriptions filled. We are planning further research on this in the future” says Dr Horsburgh.

However, Dr Horsburgh says issues relating to access of health services, such as poverty, geographical isolation and lack of reliable transport to pick up medicines or visit a doctor, are likely to be some of the reasons for the low levels of antibiotic use by rural Māori.

Professor Norris says the findings are very worrying, because of the high rates of acute rheumatic fever in this area.

“Antibiotics are very cheap, whereas the long-term costs of rheumatic fever for individuals, whanau and the health system are immense. Proactive steps need to be taken to reduce the impact of this disease in Māori communities.”