Identifying, recording and monitoring adverse effects associated with antriretroviral treatment
- Authors: Mulinge, Florence Muthoni
- Date: 2010
- Subjects: Highly active antiretroviral therapy , Antiretroviral agents -- South Africa -- Uitenhage , HIV infections -- Treatment -- South Africa -- Uitenhage , AIDS (Disease) -- Treatment -- South Africa -- Uitenhage
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10131 , http://hdl.handle.net/10948/1491 , Highly active antiretroviral therapy , Antiretroviral agents -- South Africa -- Uitenhage , HIV infections -- Treatment -- South Africa -- Uitenhage , AIDS (Disease) -- Treatment -- South Africa -- Uitenhage
- Description: South Africa, with an estimated 5.7 million people living with HIV, continues to have one of the largest epidemics in the world. The introduction of HAART resulted in prolonged and improved quality of life of many infected patients. However, adverse effects caused by these drugs have become a major concern as they affect the adherence of patients and in some cases even result in the death of patients. Although much research has been and is still being conducted in the area of understanding, preventing and management of ARV adverse effects, there is still a need for patients to be actively involved in self-monitoring for adverse effects. This will assist health care professionals in early identification of serious or potentially serious ARV effects. This study aimed at evaluating the usefulness of strategies developed and employed in the identification, recording and monitoring of adverse effects. The study was conducted with patients receiving HAART from a private HIV and AIDS clinic in Uitenhage, Eastern Cape, South Africa. The research project was approved by the Nelson Mandela Metropolitan University Research and Ethics Committee and the research site. This was an experimental, randomized controlled study carried out over a period of three months (August to October 2009), with a sample size of 160 patients divided into four study groups of 40 patients each. Two monitoring strategies, namely an ARV adverse effect monitoring tool and a patient self-monitoring diary were developed and used for the identification and recording of adverse effects. The four study groups included a Control group, a Tool group, a Diary group and a Tool-Diary group. Willing patients, after signing an informed consent form, were randomly assigned to one of the four groups by participating health care workers at the study site. Data was retrieved from the patient files by the researcher. Descriptive statistical analysis of the findings of the study was conducted using SPSS®. One hundred and forty nine patients were included in the final data analysis. Of the 80 diaries handed out to patients, only 33 were returned and due to errors only 31 were suitable for analysis. Monitoring tools were completed and analysed for 36 patients. The tool was found to be more effective in identifying adverse effects of a physical nature (such as peripheral neuropathy and lipodystrophy) than the usual methods of monitoring employed by the clinic, whilst the diary, used alone, was found to be less effective. Use of the tool and diary combined resulted in the most significant identification and recording of central nervous system related adverse effects and physical adverse effects. However due to the low return rate of the diaries and the majority of the monitoring tool not being completed in many instances the results of this study may not be generalisable. The study results did however suggest that combining the tool and the diary methods of adverse effect identification, yielded the most favourable results when compared to each method alone. This may be attributed to the fact that the tool is useful in identifying objective symptoms and the diaries subjective symptoms, particularly in instances where the patients forget to report their symptoms to healthcare professional whilst at the clinic. The diaries were also reported to improve adherence for more than 90 percentage (n=31) of the patients. More research would be needed in order to verify the exact significance of the tool and the diary in identifying and recording adverse effects and symptoms of adverse effects.
- Full Text:
- Date Issued: 2010
- Authors: Mulinge, Florence Muthoni
- Date: 2010
- Subjects: Highly active antiretroviral therapy , Antiretroviral agents -- South Africa -- Uitenhage , HIV infections -- Treatment -- South Africa -- Uitenhage , AIDS (Disease) -- Treatment -- South Africa -- Uitenhage
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10131 , http://hdl.handle.net/10948/1491 , Highly active antiretroviral therapy , Antiretroviral agents -- South Africa -- Uitenhage , HIV infections -- Treatment -- South Africa -- Uitenhage , AIDS (Disease) -- Treatment -- South Africa -- Uitenhage
- Description: South Africa, with an estimated 5.7 million people living with HIV, continues to have one of the largest epidemics in the world. The introduction of HAART resulted in prolonged and improved quality of life of many infected patients. However, adverse effects caused by these drugs have become a major concern as they affect the adherence of patients and in some cases even result in the death of patients. Although much research has been and is still being conducted in the area of understanding, preventing and management of ARV adverse effects, there is still a need for patients to be actively involved in self-monitoring for adverse effects. This will assist health care professionals in early identification of serious or potentially serious ARV effects. This study aimed at evaluating the usefulness of strategies developed and employed in the identification, recording and monitoring of adverse effects. The study was conducted with patients receiving HAART from a private HIV and AIDS clinic in Uitenhage, Eastern Cape, South Africa. The research project was approved by the Nelson Mandela Metropolitan University Research and Ethics Committee and the research site. This was an experimental, randomized controlled study carried out over a period of three months (August to October 2009), with a sample size of 160 patients divided into four study groups of 40 patients each. Two monitoring strategies, namely an ARV adverse effect monitoring tool and a patient self-monitoring diary were developed and used for the identification and recording of adverse effects. The four study groups included a Control group, a Tool group, a Diary group and a Tool-Diary group. Willing patients, after signing an informed consent form, were randomly assigned to one of the four groups by participating health care workers at the study site. Data was retrieved from the patient files by the researcher. Descriptive statistical analysis of the findings of the study was conducted using SPSS®. One hundred and forty nine patients were included in the final data analysis. Of the 80 diaries handed out to patients, only 33 were returned and due to errors only 31 were suitable for analysis. Monitoring tools were completed and analysed for 36 patients. The tool was found to be more effective in identifying adverse effects of a physical nature (such as peripheral neuropathy and lipodystrophy) than the usual methods of monitoring employed by the clinic, whilst the diary, used alone, was found to be less effective. Use of the tool and diary combined resulted in the most significant identification and recording of central nervous system related adverse effects and physical adverse effects. However due to the low return rate of the diaries and the majority of the monitoring tool not being completed in many instances the results of this study may not be generalisable. The study results did however suggest that combining the tool and the diary methods of adverse effect identification, yielded the most favourable results when compared to each method alone. This may be attributed to the fact that the tool is useful in identifying objective symptoms and the diaries subjective symptoms, particularly in instances where the patients forget to report their symptoms to healthcare professional whilst at the clinic. The diaries were also reported to improve adherence for more than 90 percentage (n=31) of the patients. More research would be needed in order to verify the exact significance of the tool and the diary in identifying and recording adverse effects and symptoms of adverse effects.
- Full Text:
- Date Issued: 2010
Implementation of intravenous to oral antibiotic switch therapy guidelines in the general medical wards of a tertiary level hospital
- Authors: Van Niekerk, Anida
- Date: 2010
- Subjects: Antibiotics -- Administration
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10160 , http://hdl.handle.net/10948/1325 , http://hdl.handle.net/10948/d1012901 , Antibiotics -- Administration
- Description: The overuse of antibiotics and consequent resistance is a common problem in medical practice worldwide. Switch therapy is a technique that can be applied to streamline antibiotic therapy reducing unnecessary prolonged Intravenous (IV) antibiotic therapy. Antibiotic switch therapy has several other benefits such as: decreasing length of hospital stay; decreasing the incidence of adverse events associated with the administration of IV antibiotics; decreasing direct and indirect hospitalisation costs while improving patients’ comfort and mobility; and decreasing the risk of acquiring nosocomial infections. Certain elements are required to make the implementation of any guideline, including a switch therapy guideline, a success and probably one of the most important is the support from a motivated multidisciplinary team. The role of such a team, in the South African context, would be filled by the Pharmacy and Therapeutics Committee (PTC). In addition, to make a guideline successful it should be continuously implemented. This responsibility traditionally falls to a pharmacist. In the United Kingdom (UK) and the United States of America (USA) pharmacists are used to promote the appropriate use of antibiotics in hospitals as this has shown to have several economic advantages. The objectives of the study were: to determine, by means of a survey, whether guidelines for IV to oral switch were employed in South African regional, tertiary and national government hospitals; to design and implement an IV to oral antibiotic switch therapy (IVOST) guideline for a local public sector tertiary level hospital; to evaluate the effectiveness of guideline implementation; and to capture, via a questionnaire, the perceptions of prescribers regarding antibiotic prescribing, including switch therapy. The Survey of Current IV Switch Therapy Practice Questionnaire was distributed to Responsible Pharmacists at regional, provincial tertiary and national central government hospitals to determine whether IVOST guidelines were employed in South African government hospitals. Following the survey, an IVOST Guideline was designed by the researcher in consultation with the Department of Medicine and the Department of Pharmacy. The IVOST Guideline was implemented following approval by the PTC at a local tertiary level government hospital. A presentation was held for prescribers, guideline documents were distributed, posters were placed in the medical wards and the ward pharmacist/researcher integrated the guideline into daily practice by placing “reminder stickers” in patient medical folders. A pre-implementation audit and two post-implementation audits, each consisting of 150 patient medical records, were conducted and compared to determine the effect of IVOST guideline implementation on prescribing patterns and to determine whether any changes could be sustained. The Prescriber Antibiotic Survey was then conducted to capture the perceptions of prescribers regarding antibiotic therapy, including switch therapy.
- Full Text:
- Date Issued: 2010
- Authors: Van Niekerk, Anida
- Date: 2010
- Subjects: Antibiotics -- Administration
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10160 , http://hdl.handle.net/10948/1325 , http://hdl.handle.net/10948/d1012901 , Antibiotics -- Administration
- Description: The overuse of antibiotics and consequent resistance is a common problem in medical practice worldwide. Switch therapy is a technique that can be applied to streamline antibiotic therapy reducing unnecessary prolonged Intravenous (IV) antibiotic therapy. Antibiotic switch therapy has several other benefits such as: decreasing length of hospital stay; decreasing the incidence of adverse events associated with the administration of IV antibiotics; decreasing direct and indirect hospitalisation costs while improving patients’ comfort and mobility; and decreasing the risk of acquiring nosocomial infections. Certain elements are required to make the implementation of any guideline, including a switch therapy guideline, a success and probably one of the most important is the support from a motivated multidisciplinary team. The role of such a team, in the South African context, would be filled by the Pharmacy and Therapeutics Committee (PTC). In addition, to make a guideline successful it should be continuously implemented. This responsibility traditionally falls to a pharmacist. In the United Kingdom (UK) and the United States of America (USA) pharmacists are used to promote the appropriate use of antibiotics in hospitals as this has shown to have several economic advantages. The objectives of the study were: to determine, by means of a survey, whether guidelines for IV to oral switch were employed in South African regional, tertiary and national government hospitals; to design and implement an IV to oral antibiotic switch therapy (IVOST) guideline for a local public sector tertiary level hospital; to evaluate the effectiveness of guideline implementation; and to capture, via a questionnaire, the perceptions of prescribers regarding antibiotic prescribing, including switch therapy. The Survey of Current IV Switch Therapy Practice Questionnaire was distributed to Responsible Pharmacists at regional, provincial tertiary and national central government hospitals to determine whether IVOST guidelines were employed in South African government hospitals. Following the survey, an IVOST Guideline was designed by the researcher in consultation with the Department of Medicine and the Department of Pharmacy. The IVOST Guideline was implemented following approval by the PTC at a local tertiary level government hospital. A presentation was held for prescribers, guideline documents were distributed, posters were placed in the medical wards and the ward pharmacist/researcher integrated the guideline into daily practice by placing “reminder stickers” in patient medical folders. A pre-implementation audit and two post-implementation audits, each consisting of 150 patient medical records, were conducted and compared to determine the effect of IVOST guideline implementation on prescribing patterns and to determine whether any changes could be sustained. The Prescriber Antibiotic Survey was then conducted to capture the perceptions of prescribers regarding antibiotic therapy, including switch therapy.
- Full Text:
- Date Issued: 2010
Implementation of the dual therapy prevention of mother-to-child transmission protocol
- Authors: Singh, Vikesh
- Date: 2010
- Subjects: HIV infections -- Transmission -- South Africa , AIDS (Disease) in pregnancy -- Prevention -- South Africa , Antiretroviral agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10138 , http://hdl.handle.net/10948/1374 , HIV infections -- Transmission -- South Africa , AIDS (Disease) in pregnancy -- Prevention -- South Africa , Antiretroviral agents
- Description: Antiretroviral drugs taken during pregnancy, reduce the rates of mother-to-child transmission from 35 percent to as low as 1 to 2 percent (UNAIDS, 2009). In 2002, the Prevention of Mother-to-Child Transmission (PMTCT) programme was implemented in South Africa. Studies on the implementation of the PMTCT programme have shown that understaffed and under-developed health care facilities were key barriers to the provision of PMTCT services (Health Systems Trust, 2002: 6; Skinner et al., 2003). The aim of this study was to assess the challenges experienced by health care workers working in public sector facilities in the Nelson Mandela Metropole after implementation of the dual therapy PMTCT programme. Four areas were investigated: Infrastructure; Drug Supply Management; Clinic Procedures and Staffing. A quantitative descriptive study was conducted in August 2009 at nine public health care facilities in the Nelson Mandela Metropole, South Africa. Questionnaires were issued to 81 nurses and 41 pharmacy personnel (pharmacists and pharmacist assistants). Checklist audit forms were issued to the Facility Manager of each facility and completed with the researcher. The key findings for Infrastructure were lack of space at patient waiting rooms (9; 100 percent n=9), counselling area (5; 55.5 percent; n=9), nurse consultation rooms (6; 66.6 percent; n=9), storage areas (5; 55.5 percent; n=9) and filing areas (7; 77.7 percent; n=9). The key findings for Drug Supply Management were none of the dispensaries (0 percent; n=10) were fully compliant with Good Pharmacy Practice, pharmacy personnel indicated that there were no stock cards for medication (13; 31.7 percent; n=41); there was less than two weeks supply of buffer stock kept for zidovudine and nevirapine (13; 35.1percent; n=37) and medication orders were placed without any reference to minimum and maximum levels of medication (15; 36.5 percent; n=41) . The key findings for Clinic Procedures were only two facilities followed up on patients that had missed appointments (22.2 percent; n=9) and four facilities (44.4 percent; n=9) had a tracking system for patients that had defaulted. Of the nine facilities only three (33.3 percent; n=9) updated patient demographic details regularly. The key findings for Staffing were a shortage of doctors, nurses, counsellors and pharmacists at the facilities. One of the major challenges identified was the lack of training offered on new PMTCT protocols with 56.2 percent (45; n=80) of the nurses stating that no training was provided on the dual PMTCT protocol. Only 54.3 percent (44; n=81) of nurses stated that they knew the criteria to start the mother on dual PMTCT therapy. In conclusion there is an urgent need for barriers such as lack of staff, lack of space, lack of training on PMTCT and standard procedures for follow up of patients to be addressed in order to ensure the successful scaling up of PMTCT.
- Full Text:
- Date Issued: 2010
- Authors: Singh, Vikesh
- Date: 2010
- Subjects: HIV infections -- Transmission -- South Africa , AIDS (Disease) in pregnancy -- Prevention -- South Africa , Antiretroviral agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10138 , http://hdl.handle.net/10948/1374 , HIV infections -- Transmission -- South Africa , AIDS (Disease) in pregnancy -- Prevention -- South Africa , Antiretroviral agents
- Description: Antiretroviral drugs taken during pregnancy, reduce the rates of mother-to-child transmission from 35 percent to as low as 1 to 2 percent (UNAIDS, 2009). In 2002, the Prevention of Mother-to-Child Transmission (PMTCT) programme was implemented in South Africa. Studies on the implementation of the PMTCT programme have shown that understaffed and under-developed health care facilities were key barriers to the provision of PMTCT services (Health Systems Trust, 2002: 6; Skinner et al., 2003). The aim of this study was to assess the challenges experienced by health care workers working in public sector facilities in the Nelson Mandela Metropole after implementation of the dual therapy PMTCT programme. Four areas were investigated: Infrastructure; Drug Supply Management; Clinic Procedures and Staffing. A quantitative descriptive study was conducted in August 2009 at nine public health care facilities in the Nelson Mandela Metropole, South Africa. Questionnaires were issued to 81 nurses and 41 pharmacy personnel (pharmacists and pharmacist assistants). Checklist audit forms were issued to the Facility Manager of each facility and completed with the researcher. The key findings for Infrastructure were lack of space at patient waiting rooms (9; 100 percent n=9), counselling area (5; 55.5 percent; n=9), nurse consultation rooms (6; 66.6 percent; n=9), storage areas (5; 55.5 percent; n=9) and filing areas (7; 77.7 percent; n=9). The key findings for Drug Supply Management were none of the dispensaries (0 percent; n=10) were fully compliant with Good Pharmacy Practice, pharmacy personnel indicated that there were no stock cards for medication (13; 31.7 percent; n=41); there was less than two weeks supply of buffer stock kept for zidovudine and nevirapine (13; 35.1percent; n=37) and medication orders were placed without any reference to minimum and maximum levels of medication (15; 36.5 percent; n=41) . The key findings for Clinic Procedures were only two facilities followed up on patients that had missed appointments (22.2 percent; n=9) and four facilities (44.4 percent; n=9) had a tracking system for patients that had defaulted. Of the nine facilities only three (33.3 percent; n=9) updated patient demographic details regularly. The key findings for Staffing were a shortage of doctors, nurses, counsellors and pharmacists at the facilities. One of the major challenges identified was the lack of training offered on new PMTCT protocols with 56.2 percent (45; n=80) of the nurses stating that no training was provided on the dual PMTCT protocol. Only 54.3 percent (44; n=81) of nurses stated that they knew the criteria to start the mother on dual PMTCT therapy. In conclusion there is an urgent need for barriers such as lack of staff, lack of space, lack of training on PMTCT and standard procedures for follow up of patients to be addressed in order to ensure the successful scaling up of PMTCT.
- Full Text:
- Date Issued: 2010
The impact of HAART on sexuality and medicine taking behaviours among people living with HIV/AIDS in Grahamstown
- Authors: Chizanga, Tongai Aldridge
- Date: 2010
- Subjects: AIDS (Disease) -- Treatment -- South Africa -- Grahamstown HIV infections -- Treatment -- South Africa -- Grahamstown Antiretroviral agents -- South Africa -- Grahamstown Patient compliance -- South Africa -- Grahamstown AIDS (Disease) -- Social aspects -- South Africa -- Grahamstown HIV infections -- Social aspects -- South Africa -- Grahamstown AIDS (Disease) -- Patients -- South Africa -- Grahamstown -- Sexual behavior HIV-positive persons -- South Africa -- Grahamstown -- Sexual behavior Patient education -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3750 , http://hdl.handle.net/10962/d1003228
- Description: Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.
- Full Text:
- Date Issued: 2010
- Authors: Chizanga, Tongai Aldridge
- Date: 2010
- Subjects: AIDS (Disease) -- Treatment -- South Africa -- Grahamstown HIV infections -- Treatment -- South Africa -- Grahamstown Antiretroviral agents -- South Africa -- Grahamstown Patient compliance -- South Africa -- Grahamstown AIDS (Disease) -- Social aspects -- South Africa -- Grahamstown HIV infections -- Social aspects -- South Africa -- Grahamstown AIDS (Disease) -- Patients -- South Africa -- Grahamstown -- Sexual behavior HIV-positive persons -- South Africa -- Grahamstown -- Sexual behavior Patient education -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3750 , http://hdl.handle.net/10962/d1003228
- Description: Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.
- Full Text:
- Date Issued: 2010
The pharmacotherapeutic treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents
- Oettle, Judith Ann Elizabeth
- Authors: Oettle, Judith Ann Elizabeth
- Date: 2010
- Subjects: Attention-deficit hyperactivity disorder -- Treatment -- South Africa , Attention-deficit hyperactivity disorder -- Alternative treatment -- South Africa , Attention-deficit-disordered children -- Treatment -- South Africa , Attention-deficit disorder in adolescence -- Treatment -- South Africa , Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10134 , http://hdl.handle.net/10948/1438 , Attention-deficit hyperactivity disorder -- Treatment -- South Africa , Attention-deficit hyperactivity disorder -- Alternative treatment -- South Africa , Attention-deficit-disordered children -- Treatment -- South Africa , Attention-deficit disorder in adolescence -- Treatment -- South Africa , Drug utilization -- South Africa
- Description: Background: The ideal treatment of Attention-Deficit/Hyperactivity Disorder is a highly debated issue. Opposition to pharmacological treatments has resulted in the popular use of non-pharmacological measures which are not necessarily efficacious for the management of ADHD. Objectives: The primary aim was to evaluate the treatment of children and adolescents diagnosed with ADHD in South Africa. Methods: The study consisted of two parts, a drug utilisation review (DUR) and questionnaire-based surveys. The DUR was conducted using a database containing central nervous system (CNS) drug prescriptions which were dispensed during 2008. A total of 21 650 prescriptions dispensed to 7 202 patients constituted the Primary study population which was analysed. The questionnaires were distributed to the parents/caregivers of children diagnosed with ADHD. A response rate of 20.81 percent was obtained. Results: The average age of patients in the DUR was 11.60 ±3.01 years. Male patients represented 74.09 percent (5 336: n = 7 202) of patients. Methylphenidate was the most commonly prescribed of the two drugs indicated for the treatment of ADHD (85.89 percent, 18 956: n = 21 650). A prescribing bias by practitioners in different parts of South Africa was identified. Drug holidays were identified during March and December of 2008. The average age of patients in the questionnaire was 10.67 ±2.83 years, with a male patient majority (86.11 percent, 31: n = 36). Methylphenidate was the most commonly used prescription treatment (93.75 percent, 30: n = 32). Drug holiday use was reported in 56.25 percent (18: n = 32) of patients. Most participants reported supplement use (83.33 percent, 30: n = 36), but 86.67 percent (26: n = 30) of these participants did not find them useful. Conclusion: ADHD is a poorly understood disorder which affects people in all spheres of life. Treatment of the disorder should be individualised and based on scientifically proven effectiveness. Further studies, both in South Africa and worldwide, need to be conducted on the treatment of ADHD
- Full Text:
- Date Issued: 2010
- Authors: Oettle, Judith Ann Elizabeth
- Date: 2010
- Subjects: Attention-deficit hyperactivity disorder -- Treatment -- South Africa , Attention-deficit hyperactivity disorder -- Alternative treatment -- South Africa , Attention-deficit-disordered children -- Treatment -- South Africa , Attention-deficit disorder in adolescence -- Treatment -- South Africa , Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10134 , http://hdl.handle.net/10948/1438 , Attention-deficit hyperactivity disorder -- Treatment -- South Africa , Attention-deficit hyperactivity disorder -- Alternative treatment -- South Africa , Attention-deficit-disordered children -- Treatment -- South Africa , Attention-deficit disorder in adolescence -- Treatment -- South Africa , Drug utilization -- South Africa
- Description: Background: The ideal treatment of Attention-Deficit/Hyperactivity Disorder is a highly debated issue. Opposition to pharmacological treatments has resulted in the popular use of non-pharmacological measures which are not necessarily efficacious for the management of ADHD. Objectives: The primary aim was to evaluate the treatment of children and adolescents diagnosed with ADHD in South Africa. Methods: The study consisted of two parts, a drug utilisation review (DUR) and questionnaire-based surveys. The DUR was conducted using a database containing central nervous system (CNS) drug prescriptions which were dispensed during 2008. A total of 21 650 prescriptions dispensed to 7 202 patients constituted the Primary study population which was analysed. The questionnaires were distributed to the parents/caregivers of children diagnosed with ADHD. A response rate of 20.81 percent was obtained. Results: The average age of patients in the DUR was 11.60 ±3.01 years. Male patients represented 74.09 percent (5 336: n = 7 202) of patients. Methylphenidate was the most commonly prescribed of the two drugs indicated for the treatment of ADHD (85.89 percent, 18 956: n = 21 650). A prescribing bias by practitioners in different parts of South Africa was identified. Drug holidays were identified during March and December of 2008. The average age of patients in the questionnaire was 10.67 ±2.83 years, with a male patient majority (86.11 percent, 31: n = 36). Methylphenidate was the most commonly used prescription treatment (93.75 percent, 30: n = 32). Drug holiday use was reported in 56.25 percent (18: n = 32) of patients. Most participants reported supplement use (83.33 percent, 30: n = 36), but 86.67 percent (26: n = 30) of these participants did not find them useful. Conclusion: ADHD is a poorly understood disorder which affects people in all spheres of life. Treatment of the disorder should be individualised and based on scientifically proven effectiveness. Further studies, both in South Africa and worldwide, need to be conducted on the treatment of ADHD
- Full Text:
- Date Issued: 2010
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