TABLE 3.

Opportunities to mitigate medication management concerns unique to neglected populations.

Confederated Salish and Kootenai Tribes (CSKT)	Partnership Health Center (PHC)	Shodair Children’s Hospital (Shodair)
“The dissemination of information from research centers to the frontlines of care delivery, especially in a frontier state like ours, is always a challenge, whether it’s precision medicine or just [the] latest cancer protocols.”—CSKT01, Physician	“I would say that our mission and vision is to provide high quality healthcare to everyone … the majority of our patients are folks who have a lot of struggles that they deal with on a daily basis, mostly socioeconomic-related, so whether they don’t have insurance, they’re homeless, the insurance they do have is really limited, they can’t afford a lot of the premiums for certain treatment, and so breaking down those barriers is a huge part of the vision here.”—PHC01, Pharmacist	“Sometimes when kids get here, they’re on a lot of different medications, and so trying to get that down to a reasonable amount, whatever that might be [is the challenge]. You can imagine [the difficulty of] a seven-year-old trying to take seven different medications. Maybe with the right management, it could be [reduced to] three or four.”—Shodair01, Administrator/Physician
“I think that there’s … a misrepresentation [that current guidelines can be universally applied to people of all ancestries] in … both the [pharmacogenetics] research and also the literature of both management options and then also barriers that some [historically disadvantaged] communities face.”—CSKT02, Physician		“A hard part that we see is kids leave here and they go back to rural communities especially, but even larger communities … some of the newer medications for some [patients] are kind of—I might use the word “scary” for some of our rural providers especially, and so they are nervous about prescribing those, so we try to give them guidance on [those medications].”—Shodair03, Administrator