Bioethical analysis of selected biomedical issues in South Africa and other countries
- Authors: Rusere, Jean
- Date: 2021-04
- Subjects: To be added
- Language: English
- Type: thesis , text , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/178530 , vital:42948
- Description: Access restricted until April 2023. , Thesis (MPharm) -- Faculty of Pharmacy, Pharmacy, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Rusere, Jean
- Date: 2021-04
- Subjects: To be added
- Language: English
- Type: thesis , text , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/178530 , vital:42948
- Description: Access restricted until April 2023. , Thesis (MPharm) -- Faculty of Pharmacy, Pharmacy, 2021
- Full Text:
- Date Issued: 2021-04
Infant health: a community-based assessment and educational intervention in two rural communities in the Eastern Cape.
- Authors: Kuzeeko, Faith
- Date: 2021
- Subjects: Angus Gillis Foundation (South Africa) , Infants -- Mortality -- South Africa , Infants -- Health and hygiene -- South Africa , Breastfeeding -- South Africa -- Eastern Cape , Infants -- Care -- Equipment and supplies , Infants -- Care -- South Africa -- Eastern Cape -- Case studies , Children -- Mortality -- South Africa , High throughput screening (Drug development)
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/170837 , vital:41964
- Description: South Africa is on track to attaining the 2030 Agenda on reducing under-five deaths to 25 deaths per 1000 live births at its current momentum, however an unacceptable amount of infants are still at risk from preventable illnesses. Malnutrition is the major underlined cause of infant mortality rates in South Africa. Exclusive breastfeeding rates are low nationwide due to low exposure to breastfeeding information, some mothers having other commitments and others having breastfeeding difficulties. Implementation and expansion of simple, cost-effective interventions, such as exclusive breastfeeding for six months to reduce and/or prevent infant mortality rates, remains low in South Africa. The aim of the study was to determine one infant health issue of major concern to participants in two rural villages in the Eastern Cape, namely Glenmore and Ndwayana. The identified infant health issue was used to design an educational intervention in the villages. This was the second phase of this study. A community-based participatory approach was utilized in which the Angus Gillis Foundation, a non-profit organization that works in these communities, was one of the stakeholders. Stock status of WHO priority medicines for infants, semi-structured interviews and focus group discussions were carried out during the baseline study. The intervention phase contained pre-2 intervention semi-structured interviews with ten pregnant women followed by an educational intervention with nine out of the ten; and finally, a post-intervention with seven out of the ten women. A questionnaire was completed by members of the Angus Gillis Foundation to provide feedback on the sustainability of the intervention. Semi-structured interviews revealed that medicines stocked at the clinic parallel those indicated in the WHO priority medicines list for infants. The results from the focus group discussions indicated that mothers do not exclusively breastfeed their infants during the first six months. Pre- and post-intervention results on exclusive breastfeeding illustrated a positive change in participants’ knowledge and intent to breastfeed exclusively for six months. They showed a better understanding of the importance of exclusive breastfeeding and indicated a more focussed intention and confidence to carry out optimal breastfeeding practices. In the questionnaire the members of the Angus Gillis Foundation stated that the intervention is sustainable as it was linked with the existing networks. These include educational programs carried out in the villages by the foundation together with positive health champions, community health workers and women self-help groups; which will be able to build on the present knowledge base. Finally, the study also included the design of a booklet on the identified infant health issue. In conclusion, participants highlighted lack of understanding regarding breastfeeding as an issue of concern during the baseline phase of the study. This community-based educational intervention improved the understanding of breastfeeding among the participants, resulting in a positive change in perception with regards to exclusive breastfeeding practices.
- Full Text:
- Date Issued: 2021
- Authors: Kuzeeko, Faith
- Date: 2021
- Subjects: Angus Gillis Foundation (South Africa) , Infants -- Mortality -- South Africa , Infants -- Health and hygiene -- South Africa , Breastfeeding -- South Africa -- Eastern Cape , Infants -- Care -- Equipment and supplies , Infants -- Care -- South Africa -- Eastern Cape -- Case studies , Children -- Mortality -- South Africa , High throughput screening (Drug development)
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/170837 , vital:41964
- Description: South Africa is on track to attaining the 2030 Agenda on reducing under-five deaths to 25 deaths per 1000 live births at its current momentum, however an unacceptable amount of infants are still at risk from preventable illnesses. Malnutrition is the major underlined cause of infant mortality rates in South Africa. Exclusive breastfeeding rates are low nationwide due to low exposure to breastfeeding information, some mothers having other commitments and others having breastfeeding difficulties. Implementation and expansion of simple, cost-effective interventions, such as exclusive breastfeeding for six months to reduce and/or prevent infant mortality rates, remains low in South Africa. The aim of the study was to determine one infant health issue of major concern to participants in two rural villages in the Eastern Cape, namely Glenmore and Ndwayana. The identified infant health issue was used to design an educational intervention in the villages. This was the second phase of this study. A community-based participatory approach was utilized in which the Angus Gillis Foundation, a non-profit organization that works in these communities, was one of the stakeholders. Stock status of WHO priority medicines for infants, semi-structured interviews and focus group discussions were carried out during the baseline study. The intervention phase contained pre-2 intervention semi-structured interviews with ten pregnant women followed by an educational intervention with nine out of the ten; and finally, a post-intervention with seven out of the ten women. A questionnaire was completed by members of the Angus Gillis Foundation to provide feedback on the sustainability of the intervention. Semi-structured interviews revealed that medicines stocked at the clinic parallel those indicated in the WHO priority medicines list for infants. The results from the focus group discussions indicated that mothers do not exclusively breastfeed their infants during the first six months. Pre- and post-intervention results on exclusive breastfeeding illustrated a positive change in participants’ knowledge and intent to breastfeed exclusively for six months. They showed a better understanding of the importance of exclusive breastfeeding and indicated a more focussed intention and confidence to carry out optimal breastfeeding practices. In the questionnaire the members of the Angus Gillis Foundation stated that the intervention is sustainable as it was linked with the existing networks. These include educational programs carried out in the villages by the foundation together with positive health champions, community health workers and women self-help groups; which will be able to build on the present knowledge base. Finally, the study also included the design of a booklet on the identified infant health issue. In conclusion, participants highlighted lack of understanding regarding breastfeeding as an issue of concern during the baseline phase of the study. This community-based educational intervention improved the understanding of breastfeeding among the participants, resulting in a positive change in perception with regards to exclusive breastfeeding practices.
- Full Text:
- Date Issued: 2021
Audit of intravenous antifungal therapy used for Candida infections at a South African private hospital
- Authors: Van Dyk, Jacklyn Kate
- Date: 2020
- Subjects: Candidiasis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46380 , vital:39600
- Description: The epidemiological landscape of the candida species has changed with the emergence of MDR strains globally and in South Africa. The aim of this study was to critically evaluate the compliance to guidelines in the use of intravenous antifungal therapy when treating invasive Candidainfections in a South African private hospital.Objective One was to determine the prevalence of Candida auris(C.auris) in the sample. Objective Two examined the relationship between high-risk patients and positive microbiological cultures. Objective Three studied the prescribing utilisation of the intravenous antifungalsin the form of a clinical audit. Objective Four compared these prescribing patternsto current guidelines by evaluating whether the antifungal course was non-compliant, of suboptimal compliance or compliant. Objective Five was to design a protocol for ward pharmacists to use when assessing antifungal treatment for candidiasis. The research design consisted of a retrospective, non-experimental, cross-sectional analysis of intravenous antifungal use in the management of systemic Candida infections in a private sector hospital in the Gauteng province, South Africa.A positive research paradigm with a quantitative clinical audit was used in this study. The most prevalent species cultured was C.auris with 31 of the 77 positive cultures. Risk stratifying patients was validated with 70% of high risk patients (Candida Score >2.5 and positive β-D-glucan) having a corresponding positive culture. Echinocandins were the most frequently utilised antifungal class, with caspofungin being the most used antifungal in the sample. The average duration of therapy for the echinocandins ranged between 11 and 16 days. Compliance to guidelines was evaluated accordingto: reason for initiation; drug choice and drug dose. Three levels of compliance were determined: non-compliant, sub-optimal compliance and compliant. xivThe overall compliance,according to recommended treatment guidelines,was found to be suboptimal, with anidentified need foranintervention which targets thedosing of the antifungals used. In conclusion, the research findings highlight the importance of reviewing antifungal prescribing habits and the need for antifungal stewardship programmes.
- Full Text:
- Date Issued: 2020
- Authors: Van Dyk, Jacklyn Kate
- Date: 2020
- Subjects: Candidiasis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46380 , vital:39600
- Description: The epidemiological landscape of the candida species has changed with the emergence of MDR strains globally and in South Africa. The aim of this study was to critically evaluate the compliance to guidelines in the use of intravenous antifungal therapy when treating invasive Candidainfections in a South African private hospital.Objective One was to determine the prevalence of Candida auris(C.auris) in the sample. Objective Two examined the relationship between high-risk patients and positive microbiological cultures. Objective Three studied the prescribing utilisation of the intravenous antifungalsin the form of a clinical audit. Objective Four compared these prescribing patternsto current guidelines by evaluating whether the antifungal course was non-compliant, of suboptimal compliance or compliant. Objective Five was to design a protocol for ward pharmacists to use when assessing antifungal treatment for candidiasis. The research design consisted of a retrospective, non-experimental, cross-sectional analysis of intravenous antifungal use in the management of systemic Candida infections in a private sector hospital in the Gauteng province, South Africa.A positive research paradigm with a quantitative clinical audit was used in this study. The most prevalent species cultured was C.auris with 31 of the 77 positive cultures. Risk stratifying patients was validated with 70% of high risk patients (Candida Score >2.5 and positive β-D-glucan) having a corresponding positive culture. Echinocandins were the most frequently utilised antifungal class, with caspofungin being the most used antifungal in the sample. The average duration of therapy for the echinocandins ranged between 11 and 16 days. Compliance to guidelines was evaluated accordingto: reason for initiation; drug choice and drug dose. Three levels of compliance were determined: non-compliant, sub-optimal compliance and compliant. xivThe overall compliance,according to recommended treatment guidelines,was found to be suboptimal, with anidentified need foranintervention which targets thedosing of the antifungals used. In conclusion, the research findings highlight the importance of reviewing antifungal prescribing habits and the need for antifungal stewardship programmes.
- Full Text:
- Date Issued: 2020
Compliance with good distribution practice guidelines for cold chain products among pharmaceutical wholesalers in South Africa
- Authors: Masebe, Zandisile
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46390 , vital:39581
- Description: Background: The South African pharmaceutical cold chain distribution industry is highly regulated. Cold chain pharmaceutical products require storage in a cold room, in a temperature-controlled environment between (2°C-8°C) and the cold chain must be maintained at all times throughout the distribution process. The incorrect handling, storage, transport and distribution of cold chain products may reduce the potency and therapeutic effectiveness of the product which in turn may result in treatment failure. The research was aimed at determining the level of compliance to current Good Distribution Practice guidelines for cold chain products among pharmaceutical wholesalers and distributors in South Africa. Methodology: The study made use of quantitative research techniques. A purpose designed online questionnaire was used as a data collection tool from the study participants. The judgmental sampling technique was used in this study as it was found to be the most appropriate method for the research question. Phase one of the study was to conduct a pilot study at two Port Elizabeth pharmaceutical wholesalers. The data was analysed using Microsoft Excel®, chi-square test for goodness of fit and content analysis. The data was further analysed using a descriptive and inferential statistics approach to determine the level of compliance to regulatory guidelines for cold chain products.Results:The results obtained from the empirical study revealed that less than 50% of the study respondents indicated compliance to the factors listed in the regulatory guidelines for cold chain products distribution.These factors include cold chain monitoring, alternative power sources, validation of cold chain boxes and route transport validation.Conclusion:The wholesale pharmaceutical industry is experiencing challenges to comply with factors necessary to ensure compliance with GDP guidelines for cold chain products. Through the study it was proven that there is evidence of commitment by the industry to implement the GWP and GPP amendment guidelines, despite less than 50% of the respondents reporting compliance to the guidelines. Recommendations were provided to improve the level of compliance to guidelines for cold chain products by pharmaceutical wholesalers in South Africa.
- Full Text:
- Date Issued: 2020
- Authors: Masebe, Zandisile
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46390 , vital:39581
- Description: Background: The South African pharmaceutical cold chain distribution industry is highly regulated. Cold chain pharmaceutical products require storage in a cold room, in a temperature-controlled environment between (2°C-8°C) and the cold chain must be maintained at all times throughout the distribution process. The incorrect handling, storage, transport and distribution of cold chain products may reduce the potency and therapeutic effectiveness of the product which in turn may result in treatment failure. The research was aimed at determining the level of compliance to current Good Distribution Practice guidelines for cold chain products among pharmaceutical wholesalers and distributors in South Africa. Methodology: The study made use of quantitative research techniques. A purpose designed online questionnaire was used as a data collection tool from the study participants. The judgmental sampling technique was used in this study as it was found to be the most appropriate method for the research question. Phase one of the study was to conduct a pilot study at two Port Elizabeth pharmaceutical wholesalers. The data was analysed using Microsoft Excel®, chi-square test for goodness of fit and content analysis. The data was further analysed using a descriptive and inferential statistics approach to determine the level of compliance to regulatory guidelines for cold chain products.Results:The results obtained from the empirical study revealed that less than 50% of the study respondents indicated compliance to the factors listed in the regulatory guidelines for cold chain products distribution.These factors include cold chain monitoring, alternative power sources, validation of cold chain boxes and route transport validation.Conclusion:The wholesale pharmaceutical industry is experiencing challenges to comply with factors necessary to ensure compliance with GDP guidelines for cold chain products. Through the study it was proven that there is evidence of commitment by the industry to implement the GWP and GPP amendment guidelines, despite less than 50% of the respondents reporting compliance to the guidelines. Recommendations were provided to improve the level of compliance to guidelines for cold chain products by pharmaceutical wholesalers in South Africa.
- Full Text:
- Date Issued: 2020
Evaluation of product x pre and post cpv implementation
- Authors: Killian, Christopher Grant
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46447 , vital:39577
- Description: Purpose: Stage 3 of the pharmaceutical process validation lifecycle, is called continued process verification (CPV). CPV is the final stage of lifecycle management and is intended to provide ongoing assurance that during routine production that a process remains in a state of control. Since CPV is a relatively new focus area for regulators, many legacy products will not have undergone Stage 3 process validation. Therefore, an opportunity existed to review the impact and challenges of implementing CPV on a legacy product. Methodology: This study employed quantitative analysis to evaluate the impact of CPV on process stability and end product quality for Product X, a legacy product manufactured at a generics manufacturing facility. Initial Stage 3a CPV was used to review historical process data and identify special cause variation. Corrective and preventative actions were taken to address these statistical outliers and the impact of these process changes were evaluated in Stage 3b. Results: CPV implementation appeared to have an effect on process control, stability and capability for Product X. In Stage 3b, an increase in statistical outliers along with significant changes to process mean and standard deviation were seen for the critical process parameters, average mass and hardness. An improvement in process capability for the critical quality attributes, assay and dissolution, was also seen. Conclusion: The largest benefit of CPV implementation, especially for a legacy product, is the process knowledge gained. This provided opportunities for process improvement and ultimately benefited patient safety.
- Full Text:
- Date Issued: 2020
- Authors: Killian, Christopher Grant
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46447 , vital:39577
- Description: Purpose: Stage 3 of the pharmaceutical process validation lifecycle, is called continued process verification (CPV). CPV is the final stage of lifecycle management and is intended to provide ongoing assurance that during routine production that a process remains in a state of control. Since CPV is a relatively new focus area for regulators, many legacy products will not have undergone Stage 3 process validation. Therefore, an opportunity existed to review the impact and challenges of implementing CPV on a legacy product. Methodology: This study employed quantitative analysis to evaluate the impact of CPV on process stability and end product quality for Product X, a legacy product manufactured at a generics manufacturing facility. Initial Stage 3a CPV was used to review historical process data and identify special cause variation. Corrective and preventative actions were taken to address these statistical outliers and the impact of these process changes were evaluated in Stage 3b. Results: CPV implementation appeared to have an effect on process control, stability and capability for Product X. In Stage 3b, an increase in statistical outliers along with significant changes to process mean and standard deviation were seen for the critical process parameters, average mass and hardness. An improvement in process capability for the critical quality attributes, assay and dissolution, was also seen. Conclusion: The largest benefit of CPV implementation, especially for a legacy product, is the process knowledge gained. This provided opportunities for process improvement and ultimately benefited patient safety.
- Full Text:
- Date Issued: 2020
Perceptions of the preparedness of pharmacy graduates for internship responsibilities in the industrial pharmacy
- Putsoane, Mathabelo Maliboche
- Authors: Putsoane, Mathabelo Maliboche
- Date: 2020
- Subjects: Pharmacy students
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46395 , vital:39593
- Description: Pharmacy graduates in South Africa are expected to undertake a compulsory one-yearinternship in diversepharmacy settings. These settings includethe industrial pharmacy sector,where they are expected to integrate furtherthe knowledge and skills they have acquired during their undergraduate training before entering into the pharmacy profession. The success of graduatesduring the internship,therefore, depends amongst other thingson their perceptions of preparedness. However, the perceptions of South African pharmacy graduates preparedness for the industrial pharmacy settingis not reportedin light of the shift in global pharmacy education from product-based to patient-based education which thus provided the impetus for this study.Semi-structured interviews with individual pharmacy graduateswere utilised to explorethe perceptions of the preparedness regarding the technical and generic skills required of an industrial pharmacy intern. Inductive data analysisculminated in thedevelopment of themes and subthemes. A lack of preparedness as perceived by graduateswas a result of a lack of industrial pharmacy experientialwork-basedpractical training and patient-focused education. Graduates perceived themselves to be fairly prepared with communication and teamwork skills; however, their problem-solving skills werenot clear due tothe scope of work ofanintern pharmacist which hinders them from solvingproblems.Though graduates expressed that they had acquired adequate theoretical training, the lack of practical application resulted in inadequate technical skills preparedness. Graduatespreparedness for the industrial pharmacy can be improved by work-based placements of students in the industry pharmacy setting which will assist students to integrate theory with practice.
- Full Text:
- Date Issued: 2020
- Authors: Putsoane, Mathabelo Maliboche
- Date: 2020
- Subjects: Pharmacy students
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46395 , vital:39593
- Description: Pharmacy graduates in South Africa are expected to undertake a compulsory one-yearinternship in diversepharmacy settings. These settings includethe industrial pharmacy sector,where they are expected to integrate furtherthe knowledge and skills they have acquired during their undergraduate training before entering into the pharmacy profession. The success of graduatesduring the internship,therefore, depends amongst other thingson their perceptions of preparedness. However, the perceptions of South African pharmacy graduates preparedness for the industrial pharmacy settingis not reportedin light of the shift in global pharmacy education from product-based to patient-based education which thus provided the impetus for this study.Semi-structured interviews with individual pharmacy graduateswere utilised to explorethe perceptions of the preparedness regarding the technical and generic skills required of an industrial pharmacy intern. Inductive data analysisculminated in thedevelopment of themes and subthemes. A lack of preparedness as perceived by graduateswas a result of a lack of industrial pharmacy experientialwork-basedpractical training and patient-focused education. Graduates perceived themselves to be fairly prepared with communication and teamwork skills; however, their problem-solving skills werenot clear due tothe scope of work ofanintern pharmacist which hinders them from solvingproblems.Though graduates expressed that they had acquired adequate theoretical training, the lack of practical application resulted in inadequate technical skills preparedness. Graduatespreparedness for the industrial pharmacy can be improved by work-based placements of students in the industry pharmacy setting which will assist students to integrate theory with practice.
- Full Text:
- Date Issued: 2020
A proposed baseline South African antimicrobial stewardship curriculum for the Bachelor of Pharmacy programme
- Authors: Khan, Yasmine
- Date: 2019
- Subjects: Pharmacy -- Study and teaching -- South Africa , Pharmacy -- Practice -- South Africa Drug utilization -- Dissertations Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/35752 , vital:33805
- Description: Antimicrobial stewardship refers to the healthcare practice which ensures the judicious and appropriate prescribing of antimicrobial agents. The primary purpose of antimicrobial stewardship entails minimising the progression of antimicrobial resistance; the rise of which is recognised as a threat to global health and safety. The pharmacist is recognised nationally and internationally as a key role player in the implementation of antimicrobial stewardship. Education of healthcare practitioners in antimicrobial stewardship is a recognised strategic enabler for the containment of antimicrobial resistance in South Africa. The primary aim of the study was to develop a proposed baseline antimicrobial stewardship curriculum which is suitable for implementation into the Bachelor of Pharmacy programmes offered by South African schools of pharmacy. The aims and objectives of the study were achieved through the conduction of four study phases: the content analysis, academic review, expert consultation and curriculum development. The content analysis investigated the structure and content of international antimicrobial stewardship curricula, and the national policy governing antimicrobial stewardship implementation in South Africa. Frequency distributions of trends from the reviewed literature informed the development of the initial draft antimicrobial stewardship curriculum for pharmacy students. In terms of content, the principles which emerges with high frequency, which were thus emphasised in the initial draft curriculum, included: the strategic objectives (governance, surveillance, antimicrobial stewardship and infection prevention); strategic enablers (education, communication, legislation and research); dose optimisation; audit and feedback; formulary restriction; collaboration; pre-authorisation; and de-escalation. Available literature did not provide extensive detail regarding the curriculum structure utilised internationally, particularly with regards to the number of contact hours dedicated to the curriculum content and the year level at which antimicrobial stewardship was incorporated in the degree programme (variable between studies). From the content analysis it was evident that a mixed methods pedagogy and use of multiple assessment techniques were recommended. The academic review phase allowed for further insight to be obtained into the content and structure of antimicrobial stewardship curriculum content which was presented in the pre-existing Bachelor of Pharmacy degree programmes. Furthermore, the academic review required that nominated participants from each school of pharmacy indicate which antimicrobial prescribing principles should be incorporated in the proposed baseline antimicrobial stewardship curriculum. The results of the academic review phase were collated with the content analysis in order to develop the updated draft antimicrobial stewardship curriculum. It was interesting to note that large variation in content and structure related to antimicrobial stewardship which was presented by the various schools of pharmacy in South Africa. In terms of curriculum content, recommendations made by academic professionals informed the development of relative importance groupings, which allowed for the various antimicrobial stewardship principles to be tiered according to importance for inclusion in the proposed baseline antimicrobial stewardship curriculum. The large variation in antimicrobial stewardship curriculum structure posed as a challenge for the development of the proposed baseline curriculum, requiring that the structure remain flexible in order for feasible incorporation into the pre-existing Bachelor of Pharmacy degree programmes offered by the various schools of pharmacy in South Africa. The expert consultation phase explored the perceptions of multiple key health disciplines who serve as part of antimicrobial stewardship teams in South Africa with regards to the role of the pharmacist in antimicrobial stewardship; and the minimum level of antimicrobial stewardship knowledge and skills which pharmacy students should possess prior to entry into practice. The results of the expert consultation phase were collated with the results of the content analysis and academic review phase in order to develop the final proposed baseline antimicrobial stewardship curriculum. The findings of the expert consultation phase indicated great variability regarding the perceived role of the pharmacist in antimicrobial stewardship within and between health disciplines. Furthermore, the relative perceived importance of various antimicrobial stewardship strategies and antimicrobial prescribing principles were explored, which informed the tiering of content in the final proposed antimicrobial stewardship curriculum.
- Full Text:
- Date Issued: 2019
- Authors: Khan, Yasmine
- Date: 2019
- Subjects: Pharmacy -- Study and teaching -- South Africa , Pharmacy -- Practice -- South Africa Drug utilization -- Dissertations Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/35752 , vital:33805
- Description: Antimicrobial stewardship refers to the healthcare practice which ensures the judicious and appropriate prescribing of antimicrobial agents. The primary purpose of antimicrobial stewardship entails minimising the progression of antimicrobial resistance; the rise of which is recognised as a threat to global health and safety. The pharmacist is recognised nationally and internationally as a key role player in the implementation of antimicrobial stewardship. Education of healthcare practitioners in antimicrobial stewardship is a recognised strategic enabler for the containment of antimicrobial resistance in South Africa. The primary aim of the study was to develop a proposed baseline antimicrobial stewardship curriculum which is suitable for implementation into the Bachelor of Pharmacy programmes offered by South African schools of pharmacy. The aims and objectives of the study were achieved through the conduction of four study phases: the content analysis, academic review, expert consultation and curriculum development. The content analysis investigated the structure and content of international antimicrobial stewardship curricula, and the national policy governing antimicrobial stewardship implementation in South Africa. Frequency distributions of trends from the reviewed literature informed the development of the initial draft antimicrobial stewardship curriculum for pharmacy students. In terms of content, the principles which emerges with high frequency, which were thus emphasised in the initial draft curriculum, included: the strategic objectives (governance, surveillance, antimicrobial stewardship and infection prevention); strategic enablers (education, communication, legislation and research); dose optimisation; audit and feedback; formulary restriction; collaboration; pre-authorisation; and de-escalation. Available literature did not provide extensive detail regarding the curriculum structure utilised internationally, particularly with regards to the number of contact hours dedicated to the curriculum content and the year level at which antimicrobial stewardship was incorporated in the degree programme (variable between studies). From the content analysis it was evident that a mixed methods pedagogy and use of multiple assessment techniques were recommended. The academic review phase allowed for further insight to be obtained into the content and structure of antimicrobial stewardship curriculum content which was presented in the pre-existing Bachelor of Pharmacy degree programmes. Furthermore, the academic review required that nominated participants from each school of pharmacy indicate which antimicrobial prescribing principles should be incorporated in the proposed baseline antimicrobial stewardship curriculum. The results of the academic review phase were collated with the content analysis in order to develop the updated draft antimicrobial stewardship curriculum. It was interesting to note that large variation in content and structure related to antimicrobial stewardship which was presented by the various schools of pharmacy in South Africa. In terms of curriculum content, recommendations made by academic professionals informed the development of relative importance groupings, which allowed for the various antimicrobial stewardship principles to be tiered according to importance for inclusion in the proposed baseline antimicrobial stewardship curriculum. The large variation in antimicrobial stewardship curriculum structure posed as a challenge for the development of the proposed baseline curriculum, requiring that the structure remain flexible in order for feasible incorporation into the pre-existing Bachelor of Pharmacy degree programmes offered by the various schools of pharmacy in South Africa. The expert consultation phase explored the perceptions of multiple key health disciplines who serve as part of antimicrobial stewardship teams in South Africa with regards to the role of the pharmacist in antimicrobial stewardship; and the minimum level of antimicrobial stewardship knowledge and skills which pharmacy students should possess prior to entry into practice. The results of the expert consultation phase were collated with the results of the content analysis and academic review phase in order to develop the final proposed baseline antimicrobial stewardship curriculum. The findings of the expert consultation phase indicated great variability regarding the perceived role of the pharmacist in antimicrobial stewardship within and between health disciplines. Furthermore, the relative perceived importance of various antimicrobial stewardship strategies and antimicrobial prescribing principles were explored, which informed the tiering of content in the final proposed antimicrobial stewardship curriculum.
- Full Text:
- Date Issued: 2019
Antimicrobial resistance awareness program at Settlers Hospital
- Manhanzva, Rufaro Immaculate
- Authors: Manhanzva, Rufaro Immaculate
- Date: 2019
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/97712 , vital:31475
- Description: Expected release date-April 2021
- Full Text: false
- Date Issued: 2019
- Authors: Manhanzva, Rufaro Immaculate
- Date: 2019
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/97712 , vital:31475
- Description: Expected release date-April 2021
- Full Text: false
- Date Issued: 2019
Collaborative health literacy development: a World Health Organization workplace health promotion approach to address tobacco use
- Authors: Duxbury, Theodore Orlando
- Date: 2019
- Subjects: Tobacco use -- Health aspects , Smoking -- Health aspects , Employee health promotion , Employee health promotion -- Computer programs , Rhodes University -- Employees -- Tobacco use
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/104116 , vital:29930
- Description: Background: Non-Communicable Diseases (NCDs) are a major global public health threat and tobacco use in particular is the leading cause of preventable illness and mortality globally. Furthermore, vulnerable and socially disadvantaged people get sicker and die sooner, especially because they are at higher risk of being exposed to harmful products such as tobacco and have limited access to health services. Tobacco use also has a major impact on the workplace, adversely affecting work productivity and increasing absenteeism. Both the living and work environments, therefore, play an important role in contributing towards the NCD epidemic. Demographics, culture, behaviour change reluctance and health literacy are all factors which exacerbate tobacco prevalence in South Africa. Workplace health promotion, however, is not well established in many workplaces. This study aimed to develop, implement and evaluate the effectiveness of a culturallysensitive and contextually-appropriate collaborative workplace health promotion literacy programme on tobacco use, utilizing tailored health information leaflets and the Rhodes University peer educators support staff, guided by the World Health Organization Workplace Health Promotion Framework. Method: The research was conducted using a participatory action research approach, which involved four phases: Firstly, the Exploratory phase assessed tobacco-related health promotion policies and practices at Rhodes University; and established facilitating and constraining factors related to tobacco use. Secondly, the Educational health promotion phase involved designing and testing a health promotion educational intervention to address tobacco use related challenges, which took the form of culturally sensitive and appropriate health information leaflets to be used as an educational intervention Thirdly, in the Implementation phase health promotion training workshops were conducted with volunteering Rhodes University Peer Educators. Finally, an Evaluation phase involved evaluating the tobacco health promotion programme presented to the Rhodes University Peer Educators through a focus group discussion; and evaluating Peer Educator recall on the tobacco related health information discussed during the training workshops through a post-post intervention questionnaire. Eight semi-structured interviews (SSIs) and seven focus group discussions (FGDs) were conducted with support staff, peer educators and key stakeholders to establish the need for a comprehensive workplace health promotion initiative, and to identify the facilitating and constraining factors to conducting such an initiative on tobacco use at the University. Three health information leaflets (HILs) were developed collaboratively with the Peer Educators following a series of scientific, end-user testing approaches. The HILs were tested for readability, comprehension, actionability and suitability. A four-day health promotion training programme was conducted to improve user friendliness, memory retention and recall of the HILs by the peer educators and to improve tobacco related health literacy aspects. The participants’ memory recall was evaluated using a pre- and post-, and post-post-intervention questionnaire to evaluate knowledge transfer. The study participants were also equipped with the completed HILs to distribute to their peers and to use as reference sources of information when needed in future. Results: The peer educators and institutional management supported the need for a tobacco workplace health promotion intervention. The intervention and evaluation phase of this study proved that health information material developed was readable, actionable, suitable, userfriendly, culturally sensitive and contextually appropriate. The workshops resulted in a significant increase in the participants’ tobacco related health knowledge. Through the adoption of a collaborative approach to the research, the participants felt empowered and ready to be agents of change amongst their peers in the workplace. Recommendations: The collective use of external expert reviewers, end-user testing techniques and validated computer programmes are recommended to improve the validity of health promotion research outcomes. A longitudinal study that focus on behaviour change, specifically, with health evaluation and monitoring aspects could be conducted as the next step to this study.
- Full Text:
- Date Issued: 2019
- Authors: Duxbury, Theodore Orlando
- Date: 2019
- Subjects: Tobacco use -- Health aspects , Smoking -- Health aspects , Employee health promotion , Employee health promotion -- Computer programs , Rhodes University -- Employees -- Tobacco use
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/104116 , vital:29930
- Description: Background: Non-Communicable Diseases (NCDs) are a major global public health threat and tobacco use in particular is the leading cause of preventable illness and mortality globally. Furthermore, vulnerable and socially disadvantaged people get sicker and die sooner, especially because they are at higher risk of being exposed to harmful products such as tobacco and have limited access to health services. Tobacco use also has a major impact on the workplace, adversely affecting work productivity and increasing absenteeism. Both the living and work environments, therefore, play an important role in contributing towards the NCD epidemic. Demographics, culture, behaviour change reluctance and health literacy are all factors which exacerbate tobacco prevalence in South Africa. Workplace health promotion, however, is not well established in many workplaces. This study aimed to develop, implement and evaluate the effectiveness of a culturallysensitive and contextually-appropriate collaborative workplace health promotion literacy programme on tobacco use, utilizing tailored health information leaflets and the Rhodes University peer educators support staff, guided by the World Health Organization Workplace Health Promotion Framework. Method: The research was conducted using a participatory action research approach, which involved four phases: Firstly, the Exploratory phase assessed tobacco-related health promotion policies and practices at Rhodes University; and established facilitating and constraining factors related to tobacco use. Secondly, the Educational health promotion phase involved designing and testing a health promotion educational intervention to address tobacco use related challenges, which took the form of culturally sensitive and appropriate health information leaflets to be used as an educational intervention Thirdly, in the Implementation phase health promotion training workshops were conducted with volunteering Rhodes University Peer Educators. Finally, an Evaluation phase involved evaluating the tobacco health promotion programme presented to the Rhodes University Peer Educators through a focus group discussion; and evaluating Peer Educator recall on the tobacco related health information discussed during the training workshops through a post-post intervention questionnaire. Eight semi-structured interviews (SSIs) and seven focus group discussions (FGDs) were conducted with support staff, peer educators and key stakeholders to establish the need for a comprehensive workplace health promotion initiative, and to identify the facilitating and constraining factors to conducting such an initiative on tobacco use at the University. Three health information leaflets (HILs) were developed collaboratively with the Peer Educators following a series of scientific, end-user testing approaches. The HILs were tested for readability, comprehension, actionability and suitability. A four-day health promotion training programme was conducted to improve user friendliness, memory retention and recall of the HILs by the peer educators and to improve tobacco related health literacy aspects. The participants’ memory recall was evaluated using a pre- and post-, and post-post-intervention questionnaire to evaluate knowledge transfer. The study participants were also equipped with the completed HILs to distribute to their peers and to use as reference sources of information when needed in future. Results: The peer educators and institutional management supported the need for a tobacco workplace health promotion intervention. The intervention and evaluation phase of this study proved that health information material developed was readable, actionable, suitable, userfriendly, culturally sensitive and contextually appropriate. The workshops resulted in a significant increase in the participants’ tobacco related health knowledge. Through the adoption of a collaborative approach to the research, the participants felt empowered and ready to be agents of change amongst their peers in the workplace. Recommendations: The collective use of external expert reviewers, end-user testing techniques and validated computer programmes are recommended to improve the validity of health promotion research outcomes. A longitudinal study that focus on behaviour change, specifically, with health evaluation and monitoring aspects could be conducted as the next step to this study.
- Full Text:
- Date Issued: 2019
Development of a framework for a proposed antimicrobial usage reporting tool for public sector hospitals
- Authors: Ramjan, Yumna
- Date: 2019
- Subjects: Anti-infective agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/43030 , vital:36727
- Description: Background: The inappropriate and unnecessary use of antimicrobials has increased the need to monitor antimicrobial usage so as to identify inappropriate use. In order to support the antimicrobial stewardship (AMS) programme, it is important to quantify the usage of antimicrobials and this can be achieved by promoting the use of AMS utilisation metrics. They are used to measure the progress and efficacy of an AMS programme (Brotherton, 2018).Primary Aim of Research: The primary aim of the research was to develop a framework for a proposed antimicrobial usage reporting tool, which would integrate with various data sources in order to be used by AMS practitioners to optimise antimicrobial usage in the South African public sector hospital setting.Methodology: The study was divided into three phases: a preliminary phase, a developmental phase and a post-developmental phase. The preliminary phase focused on obtaining a comprehensive understanding of the type and nature of the AMS utilisation metrics and subsequently identifying the views on the usage, usefulness and clinical relevance of those AMS utilisation metrics using a quantitative questionnaire, which was conducted among infectious disease specialists, pharmacists, medical prescribers, i.e. prescribers who were not specialists and clinical pathologists employed at tertiary level, public sector hospitals in the Eastern Cape province of South Africa. Consequently, a qualitative semi-structured interview was conducted among healthcare professionals who were involved in the daily implementation of AMS in the workplace. Results obtained from the quantitative component and qualitative component were integrated in order to develop a framework for a proposed antimicrobial usage reporting tool. Results: The Defined Daily Dose (DDD), Prescribed Daily Dose (PDD) and Days of Therapy (DOT) were identified as the most common AMS metrics (Grau et al., 2013). However, the DDD was the only AMS metric currently recommended by the South African National Department of Health (South African National Department of Health, 2017a)and it was the only AMS metric currently being utilised at two of the five research sites in the Eastern Cape province of South Africa. It was identified that data pertaining to antimicrobial usage was available and was being extracted from Rx Solution®. However, the programme did not have the ability of automatically producing the reports, hence, emphasising on the need for an antimicrobial usage reporting tool for South African public sector hospitals. Therefore, the framework for the proposed antimicrobial usage reporting tool would integrate antimicrobial stock management data with the following AMS utilisation metrics: DDD, DOT and PDD, were considered for inclusion in the proposed antimicrobial usage reporting tool. Conclusion: The qualitative findings obtained during the post-developmental phase, therefore, established that although an electronic platform for the purpose of monitoring antimicrobial usage for the South African public sector hospitals was required, there would be many challenges obstructing the implementation of the proposed antimicrobial usage reporting tool.
- Full Text:
- Date Issued: 2019
- Authors: Ramjan, Yumna
- Date: 2019
- Subjects: Anti-infective agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/43030 , vital:36727
- Description: Background: The inappropriate and unnecessary use of antimicrobials has increased the need to monitor antimicrobial usage so as to identify inappropriate use. In order to support the antimicrobial stewardship (AMS) programme, it is important to quantify the usage of antimicrobials and this can be achieved by promoting the use of AMS utilisation metrics. They are used to measure the progress and efficacy of an AMS programme (Brotherton, 2018).Primary Aim of Research: The primary aim of the research was to develop a framework for a proposed antimicrobial usage reporting tool, which would integrate with various data sources in order to be used by AMS practitioners to optimise antimicrobial usage in the South African public sector hospital setting.Methodology: The study was divided into three phases: a preliminary phase, a developmental phase and a post-developmental phase. The preliminary phase focused on obtaining a comprehensive understanding of the type and nature of the AMS utilisation metrics and subsequently identifying the views on the usage, usefulness and clinical relevance of those AMS utilisation metrics using a quantitative questionnaire, which was conducted among infectious disease specialists, pharmacists, medical prescribers, i.e. prescribers who were not specialists and clinical pathologists employed at tertiary level, public sector hospitals in the Eastern Cape province of South Africa. Consequently, a qualitative semi-structured interview was conducted among healthcare professionals who were involved in the daily implementation of AMS in the workplace. Results obtained from the quantitative component and qualitative component were integrated in order to develop a framework for a proposed antimicrobial usage reporting tool. Results: The Defined Daily Dose (DDD), Prescribed Daily Dose (PDD) and Days of Therapy (DOT) were identified as the most common AMS metrics (Grau et al., 2013). However, the DDD was the only AMS metric currently recommended by the South African National Department of Health (South African National Department of Health, 2017a)and it was the only AMS metric currently being utilised at two of the five research sites in the Eastern Cape province of South Africa. It was identified that data pertaining to antimicrobial usage was available and was being extracted from Rx Solution®. However, the programme did not have the ability of automatically producing the reports, hence, emphasising on the need for an antimicrobial usage reporting tool for South African public sector hospitals. Therefore, the framework for the proposed antimicrobial usage reporting tool would integrate antimicrobial stock management data with the following AMS utilisation metrics: DDD, DOT and PDD, were considered for inclusion in the proposed antimicrobial usage reporting tool. Conclusion: The qualitative findings obtained during the post-developmental phase, therefore, established that although an electronic platform for the purpose of monitoring antimicrobial usage for the South African public sector hospitals was required, there would be many challenges obstructing the implementation of the proposed antimicrobial usage reporting tool.
- Full Text:
- Date Issued: 2019
Formulation, development and assessment of an orodispersible taste masked sildenafil film for paediatric use
- Authors: Naidu, Hariska
- Date: 2019
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/97635 , vital:31466
- Description: Expected release date-April 2021
- Full Text: false
- Date Issued: 2019
- Authors: Naidu, Hariska
- Date: 2019
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/97635 , vital:31466
- Description: Expected release date-April 2021
- Full Text: false
- Date Issued: 2019
Multi-drug resistant tuberculosis related adverse drug reactions: implementation of a documentation tool
- Authors: Cheng, Amber
- Date: 2019
- Subjects: Multi-drug resistant tuberculosis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/44662 , vital:38151
- Description: Multi-drug resistant tuberculosis (MDR-TB) is an ever-growing problem in South Africa (SA). According to the literature, minimal documentation is done on adverse drug reactions (ADRs), specifically in the MDR-TB population. Co-administration of medications is typical for the treatment of drug resistant forms of TB, which leads to high incidences of ADRs during the treatment period, especially in patients with comorbid disease states. This before-and-after study investigated the impact of an intervention (education training presentation and implementation of a purpose-designed documentation tool) on the current documentation pattern in a public sector hospital in the Nelson Mandela Metropole. In order to measure the sustainability of the intervention, the study compared data from the pre-intervention phase to data collected from the post-intervention immediate phase and post-intervention delayed phase. Study results indicated that the intervention appeared to have had a positive effect on the frequency and variety of ADR documentation (2.1 and 1.3 fold increase, respectively) related to MDR-TB by the hospital staff of a public sector hospital, however, the positive change was not sustainable for longer than a three month period post intervention. It is recommended that factors such as: proper adoption; management; and additional resources are required to implement positive changes to documentation practices. Further studies need to be conducted in South Africa regarding the treatment of drug resistant tuberculosis, in order to establish safer treatment guidelines and more promising ADR reporting practices, which will ultimately improve patient care.
- Full Text:
- Date Issued: 2019
- Authors: Cheng, Amber
- Date: 2019
- Subjects: Multi-drug resistant tuberculosis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/44662 , vital:38151
- Description: Multi-drug resistant tuberculosis (MDR-TB) is an ever-growing problem in South Africa (SA). According to the literature, minimal documentation is done on adverse drug reactions (ADRs), specifically in the MDR-TB population. Co-administration of medications is typical for the treatment of drug resistant forms of TB, which leads to high incidences of ADRs during the treatment period, especially in patients with comorbid disease states. This before-and-after study investigated the impact of an intervention (education training presentation and implementation of a purpose-designed documentation tool) on the current documentation pattern in a public sector hospital in the Nelson Mandela Metropole. In order to measure the sustainability of the intervention, the study compared data from the pre-intervention phase to data collected from the post-intervention immediate phase and post-intervention delayed phase. Study results indicated that the intervention appeared to have had a positive effect on the frequency and variety of ADR documentation (2.1 and 1.3 fold increase, respectively) related to MDR-TB by the hospital staff of a public sector hospital, however, the positive change was not sustainable for longer than a three month period post intervention. It is recommended that factors such as: proper adoption; management; and additional resources are required to implement positive changes to documentation practices. Further studies need to be conducted in South Africa regarding the treatment of drug resistant tuberculosis, in order to establish safer treatment guidelines and more promising ADR reporting practices, which will ultimately improve patient care.
- Full Text:
- Date Issued: 2019
Pharmacists’ perceptions of the effects of the Consumer Protection Act of 2008 on the pharmacy profession in South Africa: an exploratory study
- Authors: Cumberlege, Karin
- Date: 2019
- Subjects: South Africa -- Consumer Protection Act, 2008 , Consumer protection -- Law and legislation -- South Africa Pharmacists -- Legal status, laws, etc. -- South Africa Pharmacy -- Practice -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/38057 , vital:34312
- Description: The pharmacy profession is highly regulated through a number of statutes and codes all of which are devised in the public interest. The Consumer Protection Act, No 68 of 2008 (CPA) is a relatively recent addition to these regulatory measures and purports to protect consumers in their relations with suppliers, which includes the pharmacist-patient relationship. Heightened consumer awareness is increasing litigious consumer behaviour, making it important for pharmacists to be aware of their legal duties as providers of pharmaceutical care to consumers and therefore, to appreciate the potential implications of the CPA. This study aimed to determine South African pharmacists’ perceptions of the potential effect of the CPA on the pharmacy profession. Specific objectives included establishing the extent to which pharmacy law and ethics are incorporated into pharmacy curricula at various tertiary pharmacy institutions. The literature review identified the pharmacy categories providing pharmaceutical care services, whilst investigating medico-legal aspects of such services. Selected consumer rights in the CPA were considered in the context of pharmacists’ ethical obligations to consumers, thereby identifying potential areas of liability for pharmacists. Content and curriculum development pertaining to pharmacy education and training, focusing on pharmacy law and ethics, were assessed. A mixed methods research design was used to achieve the aim of the study. This included focus groups, telephone interviews, and a questionnaire survey amongst registered pharmacists. The themes identified in the focus groups were included in the telephone interviews. Likewise, themes identified from both the focus groups and telephone interviews, were incorporated in the questionnaire survey. The results identified a disparity in pharmacists’ education and training received from the respective tertiary pharmacy institutions. The results showed that pharmacists do not necessarily appreciate the potential implications of the CPA for pharmacists, portending an increased likelihood of liability. This finding also has implications for the training of pharmacists.
- Full Text:
- Date Issued: 2019
- Authors: Cumberlege, Karin
- Date: 2019
- Subjects: South Africa -- Consumer Protection Act, 2008 , Consumer protection -- Law and legislation -- South Africa Pharmacists -- Legal status, laws, etc. -- South Africa Pharmacy -- Practice -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/38057 , vital:34312
- Description: The pharmacy profession is highly regulated through a number of statutes and codes all of which are devised in the public interest. The Consumer Protection Act, No 68 of 2008 (CPA) is a relatively recent addition to these regulatory measures and purports to protect consumers in their relations with suppliers, which includes the pharmacist-patient relationship. Heightened consumer awareness is increasing litigious consumer behaviour, making it important for pharmacists to be aware of their legal duties as providers of pharmaceutical care to consumers and therefore, to appreciate the potential implications of the CPA. This study aimed to determine South African pharmacists’ perceptions of the potential effect of the CPA on the pharmacy profession. Specific objectives included establishing the extent to which pharmacy law and ethics are incorporated into pharmacy curricula at various tertiary pharmacy institutions. The literature review identified the pharmacy categories providing pharmaceutical care services, whilst investigating medico-legal aspects of such services. Selected consumer rights in the CPA were considered in the context of pharmacists’ ethical obligations to consumers, thereby identifying potential areas of liability for pharmacists. Content and curriculum development pertaining to pharmacy education and training, focusing on pharmacy law and ethics, were assessed. A mixed methods research design was used to achieve the aim of the study. This included focus groups, telephone interviews, and a questionnaire survey amongst registered pharmacists. The themes identified in the focus groups were included in the telephone interviews. Likewise, themes identified from both the focus groups and telephone interviews, were incorporated in the questionnaire survey. The results identified a disparity in pharmacists’ education and training received from the respective tertiary pharmacy institutions. The results showed that pharmacists do not necessarily appreciate the potential implications of the CPA for pharmacists, portending an increased likelihood of liability. This finding also has implications for the training of pharmacists.
- Full Text:
- Date Issued: 2019
Pharmacy personnel practices with regard to the sale of non-prescription asthma medication in community pharmacies in the Eastern and Western Cape
- Gebers, Benjamin Herman Charles
- Authors: Gebers, Benjamin Herman Charles
- Date: 2019
- Subjects: Pharmacy -- Practice , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical services -- South Africa Western Cape Drug utilization Asthma
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/39752 , vital:35354
- Description: Short Acting Beta Agonist (SABA) inhalers in South Africa are available to patients without a prescription from an authorised prescriber. This study utilised a mystery shopping technique to observe, record and compare the dispensing practices of pharmacy personnel, when dispensing a reliever inhaler, to the minimum requirements set out by the South African Pharmacy Council. The results of this study indicated that there was no adherence to the minimum requirements when dispensing a reliever inhaler.
- Full Text:
- Date Issued: 2019
- Authors: Gebers, Benjamin Herman Charles
- Date: 2019
- Subjects: Pharmacy -- Practice , Pharmaceutical services -- South Africa -- Eastern Cape Pharmaceutical services -- South Africa Western Cape Drug utilization Asthma
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/39752 , vital:35354
- Description: Short Acting Beta Agonist (SABA) inhalers in South Africa are available to patients without a prescription from an authorised prescriber. This study utilised a mystery shopping technique to observe, record and compare the dispensing practices of pharmacy personnel, when dispensing a reliever inhaler, to the minimum requirements set out by the South African Pharmacy Council. The results of this study indicated that there was no adherence to the minimum requirements when dispensing a reliever inhaler.
- Full Text:
- Date Issued: 2019
Simulated learning: integrating clinical knowledge into the dispensing process
- Authors: Klitsie, Monique
- Date: 2019
- Subjects: Medicine -- Study and teaching -- Simulation methods , Pharmacy -- Study and teaching Hospital pharmacies -- South Africa Pharmacy management -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/42239 , vital:36638
- Description: Pharmacy education has experienced a continual shift in the emphasis of the practice of pharmacy, requiring pharmacists to practice high levels of competence in performing the dispensing process while incorporating clinical knowledge using complex levels of cognitive skill. This highlights the need for opportunities within the learning environment which both require and facilitate the integration of clinical knowledge-based cognitive skills into the dispensing process. Simulation-based education has been demonstrated to assist in gradually increasing the level of complexity of tasks requiring performance by students in clinical settings. This study explored ways in which a computer-based dispensing program, MyDispense, could be used to facilitate the integration of clinical knowledge-based cognitive skills into the dispensing process. In the study, simulated patient scenarios for MyDispense were developed, which required the integration of a hierarchy of cognitive skills into the dispensing process. These were evaluated in order to assess the level of cognitive skills required to complete the clinical scenarios created. The developed MyDispense-based clinical scenarios were then piloted with a group of pharmacy students, after which a focus group was used to explore the students’ experience of the ability of MyDispense to integrate clinical knowledge into the dispensing process. This qualitative study adopted an exploratory approach in order to understand the potential benefit of computer-based simulated learning as a means of integrating clinical knowledge-based cognitive skills into the dispensing process. Purposive and convenience sampling was used in this study and data collection was through the completion of purpose-designed assessment forms by pharmacy lecturers and focus groups with student participants. Data from the assessment forms was used as feedback to further refine the clinical scenarios, and the focus group recording was transcribed and analysed using a thematic analysis approach. The scenarios assessed by the pharmacy lecturers were shown to require high levels of cognitive skills as described by Bloom’s Revised Taxonomy (Anderson & Krathwohl, 2001) and necessitated that the students plan, construct, design, and generate information to complete the scenarios. The pharmacy students successfully practiced the MyDispense scenarios as an adjunct to a clinical module and reported that the scenarios had assisted them in learning for the clinical module. The students acknowledged that they were required to apply their clinical knowledge and make clinical decisions while completing the scenarios. This study demonstrates that simulation-based education can be used as a beneficial educational tool for teaching the application of complex clinical knowledge-based cognitive skills to the dispensing process. It provides a valuable means of preparing students for professional work-based pharmacy practice.
- Full Text:
- Date Issued: 2019
- Authors: Klitsie, Monique
- Date: 2019
- Subjects: Medicine -- Study and teaching -- Simulation methods , Pharmacy -- Study and teaching Hospital pharmacies -- South Africa Pharmacy management -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/42239 , vital:36638
- Description: Pharmacy education has experienced a continual shift in the emphasis of the practice of pharmacy, requiring pharmacists to practice high levels of competence in performing the dispensing process while incorporating clinical knowledge using complex levels of cognitive skill. This highlights the need for opportunities within the learning environment which both require and facilitate the integration of clinical knowledge-based cognitive skills into the dispensing process. Simulation-based education has been demonstrated to assist in gradually increasing the level of complexity of tasks requiring performance by students in clinical settings. This study explored ways in which a computer-based dispensing program, MyDispense, could be used to facilitate the integration of clinical knowledge-based cognitive skills into the dispensing process. In the study, simulated patient scenarios for MyDispense were developed, which required the integration of a hierarchy of cognitive skills into the dispensing process. These were evaluated in order to assess the level of cognitive skills required to complete the clinical scenarios created. The developed MyDispense-based clinical scenarios were then piloted with a group of pharmacy students, after which a focus group was used to explore the students’ experience of the ability of MyDispense to integrate clinical knowledge into the dispensing process. This qualitative study adopted an exploratory approach in order to understand the potential benefit of computer-based simulated learning as a means of integrating clinical knowledge-based cognitive skills into the dispensing process. Purposive and convenience sampling was used in this study and data collection was through the completion of purpose-designed assessment forms by pharmacy lecturers and focus groups with student participants. Data from the assessment forms was used as feedback to further refine the clinical scenarios, and the focus group recording was transcribed and analysed using a thematic analysis approach. The scenarios assessed by the pharmacy lecturers were shown to require high levels of cognitive skills as described by Bloom’s Revised Taxonomy (Anderson & Krathwohl, 2001) and necessitated that the students plan, construct, design, and generate information to complete the scenarios. The pharmacy students successfully practiced the MyDispense scenarios as an adjunct to a clinical module and reported that the scenarios had assisted them in learning for the clinical module. The students acknowledged that they were required to apply their clinical knowledge and make clinical decisions while completing the scenarios. This study demonstrates that simulation-based education can be used as a beneficial educational tool for teaching the application of complex clinical knowledge-based cognitive skills to the dispensing process. It provides a valuable means of preparing students for professional work-based pharmacy practice.
- Full Text:
- Date Issued: 2019
Workplace health promotion at Rhodes University: harmful use of alcohol
- Authors: Marara, Praise
- Date: 2019
- Subjects: Chronic diseases -- South Africa , Health education -- South Africa , Drinking of alcoholic beverages -- Health aspects -- South Africa , Employees -- Alcohol use -- South Africa , Employee health promotion -- South Africa , Rhodes University -- Employees -- Health and hygiene
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/67444 , vital:29088
- Description: Background: Non-communicable diseases (NCDs) are responsible for 38 million deaths annually, which translates to 68% of global deaths every year. Incidence and prevalence of NCDs are increasing rapidly and the poor bear a disproportionate burden. The increase in NCDs has been primarily due to a proliferation of modifiable risk factors, such as unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Substance abuse, mainly of alcohol, is a common cause of health problems in almost all countries across the globe. Alcohol abuse is a major contributor to the global burden of diseases and accounts for 3.3 million deaths, approximately 5.9% of all global deaths, annually. Alcohol misuse is the fifth leading risk factor for premature death and disability and is the top risk factor among people between 15 and 49 years of age. The rise of harmful use of alcohol in South Africa contributes to the disease burden faced by the country, with alcohol-related disorders making up 44.6% of all alcohol-attributable disabilities. Strategies to reduce harmful use of alcohol include national policies and educational interventions including health promotion. Health promotion is a common practice in the prevention of NCDs, but workplace health promotion has not yet been well established in many workplaces. Identification of past workplace initiatives and exploring their facilitating and limiting factors is thus important to consider when planning future initiatives. Raising awareness on harmful use of alcohol through workplace health promotion projects can help to prevent and reduce alcohol-related problems. For these health promotion activities to succeed, they need to be developed with consideration of factors such as the environment, culture, and socio-economic standing of the intended target population. Method: This study, conducted at Rhodes University, followed a mixed methods research approach and consisted of two phases. The first phase of the current study was a needs assessment and involved working with the key stakeholders. Using the Community Based Participatory Research approach and the Centres for Disease Control and prevention workplace health model to guide the research, five semi-structured interviews were conducted with key stakeholders to identify factors affecting workplace health promotion, and their opinions on how to improve these initiatives were sought. The participants were asked to identify areas on which the intended intervention should focus, as well as to identify their preferred means of communicating health messages. During this phase, a group of peer educators who volunteered their involvement in the health promotion project focusing on harmful use of alcohol was also identified. The second phase of this project aimed to address concerns raised in the first phase through a health promotion initiative for support staff that focuses on the prevention of NCDs diseases through reducing alcohol related harm. During the educational health promotion phase of the study, three health information leaflets based on harmful use of alcohol were designed. These leaflets went through a series of evaluations by the researchers’ peers, support staff during a pilot study, peer educators and other health professionals to assess content validity, context specificity, and cultural appropriateness for the target group. The health information leaflets were then used as written materials in the educational intervention of the project and were also used to design a poster. Through participatory involvement, a facilitator’s manual on harmful use of alcohol was developed, which was used during the workshops in the implementation phase of the research. The facilitator’s manual was modified based on provided feedback on improving the content of the facilitator’s manual. The readability of the manual was also performed to make it suitable for the end users. The peer educators were also trained through workshops to enable them to promote and raise awareness on harmful use of alcohol to others in the workplace. Workshops were participatory in nature and were also equipped with the completed health information leaflets to distribute to their peers and to use as reference sources of information when needed. Results: Participants in the semi-structured interviews reported that some health promotion initiatives have previously been attempted and advertised to support staff, but there was poor participant participation. Peer educators reported that these initiatives were not communicated to them and venues and work commitments sometimes were barriers to participation in these projects. The peer educators suggested incentivising initiatives for better participation. Another key suggestion was to inform and to include their managers and supervisors in these initiatives so they are permitted to take time off work. Health education material like posters or leaflets were also proposed as modes of delivering health information. During the design of the material to be used for this project’s intended intervention, the health information leaflets were deemed readable, suitable, actionable, context-specific, and culturally appropriate. Workshops conducted during Phase 2 of the study proved to be valuable in training peer educators. Peer educators also deemed the workshops useful, and reported their readiness to be agents of change in the workplace. Conclusions: Based on the input of key stakeholders and peer educators, there is currently no health promotion policy at Rhodes University, especially with respect to NCDs health promotion policies and protocols for NCDs. Health promotion initiatives, especially for support staff, that address NCDs have previously been attempted at the university but were not successful. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful when implementing the health promotion project on harmful use of alcohol. The health leaflets were deemed suitable for use by the target population. Peer educators who went through the workshops and were provided with the facilitators’ manuals concluded that the sessions were useful in their continued participation in the health promotion project. Continued involvement of the Wellness Office and peer educators can assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2019
- Authors: Marara, Praise
- Date: 2019
- Subjects: Chronic diseases -- South Africa , Health education -- South Africa , Drinking of alcoholic beverages -- Health aspects -- South Africa , Employees -- Alcohol use -- South Africa , Employee health promotion -- South Africa , Rhodes University -- Employees -- Health and hygiene
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/67444 , vital:29088
- Description: Background: Non-communicable diseases (NCDs) are responsible for 38 million deaths annually, which translates to 68% of global deaths every year. Incidence and prevalence of NCDs are increasing rapidly and the poor bear a disproportionate burden. The increase in NCDs has been primarily due to a proliferation of modifiable risk factors, such as unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Substance abuse, mainly of alcohol, is a common cause of health problems in almost all countries across the globe. Alcohol abuse is a major contributor to the global burden of diseases and accounts for 3.3 million deaths, approximately 5.9% of all global deaths, annually. Alcohol misuse is the fifth leading risk factor for premature death and disability and is the top risk factor among people between 15 and 49 years of age. The rise of harmful use of alcohol in South Africa contributes to the disease burden faced by the country, with alcohol-related disorders making up 44.6% of all alcohol-attributable disabilities. Strategies to reduce harmful use of alcohol include national policies and educational interventions including health promotion. Health promotion is a common practice in the prevention of NCDs, but workplace health promotion has not yet been well established in many workplaces. Identification of past workplace initiatives and exploring their facilitating and limiting factors is thus important to consider when planning future initiatives. Raising awareness on harmful use of alcohol through workplace health promotion projects can help to prevent and reduce alcohol-related problems. For these health promotion activities to succeed, they need to be developed with consideration of factors such as the environment, culture, and socio-economic standing of the intended target population. Method: This study, conducted at Rhodes University, followed a mixed methods research approach and consisted of two phases. The first phase of the current study was a needs assessment and involved working with the key stakeholders. Using the Community Based Participatory Research approach and the Centres for Disease Control and prevention workplace health model to guide the research, five semi-structured interviews were conducted with key stakeholders to identify factors affecting workplace health promotion, and their opinions on how to improve these initiatives were sought. The participants were asked to identify areas on which the intended intervention should focus, as well as to identify their preferred means of communicating health messages. During this phase, a group of peer educators who volunteered their involvement in the health promotion project focusing on harmful use of alcohol was also identified. The second phase of this project aimed to address concerns raised in the first phase through a health promotion initiative for support staff that focuses on the prevention of NCDs diseases through reducing alcohol related harm. During the educational health promotion phase of the study, three health information leaflets based on harmful use of alcohol were designed. These leaflets went through a series of evaluations by the researchers’ peers, support staff during a pilot study, peer educators and other health professionals to assess content validity, context specificity, and cultural appropriateness for the target group. The health information leaflets were then used as written materials in the educational intervention of the project and were also used to design a poster. Through participatory involvement, a facilitator’s manual on harmful use of alcohol was developed, which was used during the workshops in the implementation phase of the research. The facilitator’s manual was modified based on provided feedback on improving the content of the facilitator’s manual. The readability of the manual was also performed to make it suitable for the end users. The peer educators were also trained through workshops to enable them to promote and raise awareness on harmful use of alcohol to others in the workplace. Workshops were participatory in nature and were also equipped with the completed health information leaflets to distribute to their peers and to use as reference sources of information when needed. Results: Participants in the semi-structured interviews reported that some health promotion initiatives have previously been attempted and advertised to support staff, but there was poor participant participation. Peer educators reported that these initiatives were not communicated to them and venues and work commitments sometimes were barriers to participation in these projects. The peer educators suggested incentivising initiatives for better participation. Another key suggestion was to inform and to include their managers and supervisors in these initiatives so they are permitted to take time off work. Health education material like posters or leaflets were also proposed as modes of delivering health information. During the design of the material to be used for this project’s intended intervention, the health information leaflets were deemed readable, suitable, actionable, context-specific, and culturally appropriate. Workshops conducted during Phase 2 of the study proved to be valuable in training peer educators. Peer educators also deemed the workshops useful, and reported their readiness to be agents of change in the workplace. Conclusions: Based on the input of key stakeholders and peer educators, there is currently no health promotion policy at Rhodes University, especially with respect to NCDs health promotion policies and protocols for NCDs. Health promotion initiatives, especially for support staff, that address NCDs have previously been attempted at the university but were not successful. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful when implementing the health promotion project on harmful use of alcohol. The health leaflets were deemed suitable for use by the target population. Peer educators who went through the workshops and were provided with the facilitators’ manuals concluded that the sessions were useful in their continued participation in the health promotion project. Continued involvement of the Wellness Office and peer educators can assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2019
Application of a quality by design approach to optimise an existing product
- Authors: Maxwell, Taryn Lee
- Date: 2018
- Subjects: Pharmaceutical chemistry , Drugs -- Design Pharmaceutical technology
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/32752 , vital:32341
- Description: Quality by design is a science and risk based approach whereby quality is built into the product or process during the pharmaceutical development. although quality by design is encouraged for pharmaceutical development. it is possible to apply quality by design to optimize an existing product as part of a continual improvement strategy. the purpose of this study is to determine which factors should be considered to justify the application of quality by design to optimize an existing product.
- Full Text: false
- Date Issued: 2018
- Authors: Maxwell, Taryn Lee
- Date: 2018
- Subjects: Pharmaceutical chemistry , Drugs -- Design Pharmaceutical technology
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/32752 , vital:32341
- Description: Quality by design is a science and risk based approach whereby quality is built into the product or process during the pharmaceutical development. although quality by design is encouraged for pharmaceutical development. it is possible to apply quality by design to optimize an existing product as part of a continual improvement strategy. the purpose of this study is to determine which factors should be considered to justify the application of quality by design to optimize an existing product.
- Full Text: false
- Date Issued: 2018
Barriers to picking and packing in pharmaceutical warehousing and distribution in South Africa
- Authors: Kemp, Nicholas
- Date: 2018
- Subjects: Pharmaceutical industry -- Materials management , Warehouses -- Management Pharmaceutical industry -- South Africa Physical distribution of goods -- Management
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30627 , vital:30994
- Description: Barriers within the supply chain play an evident role in decreasing its efficiency. The supply chain system is not well documented in the pharmaceutical sector. The aim of this study was to identify any barriers to the movement of picking and packing operators within 6 distribution facilities throughout South Africa using a time and motion analysis. A pilot study was initially conducted to choose the stopwatch application for Android® devices and to ensure reliability of the tools utilised. The motions during the processes of fulfilling an order were identified during the case picking, bulk picking and packing processes by direct observation of operators. The direct observation was performed using a stopwatch application for Android® devices and a tool on Microsoft Excel®. The data was analysed using Microsoft Excel®, using a student’s T-test and an analysis of variance (ANOVA) approach to identify similarities and differences between the facilities. The data was further analysed using a descriptive statistics approach to identify the common barriers amongst the distribution centres. Thereafter, the data was analysed by identifying a value-quotient. The value-quotient was used to identify how much time was spent on value-adding activities with each facility. The observation of the operators was done randomly at each facility to avoid subjectivity and bias. Results: The pilot study identified which stopwatch application was to be utilised. The pilot study aided to improve upon the design of the data collection tool used for the transcribing of the timing operation. The student’s T-test and ANOVA revealed that there were statistically significant differences in case picking amongst facilities, namely using the radio frequency identification devices (RFID), picking and transfer of stock. In the bulk picking process, there was a statistically significant difference amongst the facilities, namely using the RFID, pick and transfer of stock. In the packing process there was a statistically significant difference amongst the facilities in the packing process. The analysis of barriers within the distribution centres revealed that the 16 common barriers amongst the picking processes at the facilities included raising the platform, waiting for colleagues to depart an aisle, RFID malfunctions and answering their phones. No common barriers during the packing process was identified. The value-quotient revealed that most of the facilities spent more than 50 percent of their time on value-adding activities during the case picking, bulk picking and packing processes. A time and motion analysis proved to be an effective method to identify similarities and barriers between the six facilities. It was recommended to investigate a few of the basic operations to improve upon, as well as the possibility of implementing a barcoded system to the stock.
- Full Text:
- Date Issued: 2018
- Authors: Kemp, Nicholas
- Date: 2018
- Subjects: Pharmaceutical industry -- Materials management , Warehouses -- Management Pharmaceutical industry -- South Africa Physical distribution of goods -- Management
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30627 , vital:30994
- Description: Barriers within the supply chain play an evident role in decreasing its efficiency. The supply chain system is not well documented in the pharmaceutical sector. The aim of this study was to identify any barriers to the movement of picking and packing operators within 6 distribution facilities throughout South Africa using a time and motion analysis. A pilot study was initially conducted to choose the stopwatch application for Android® devices and to ensure reliability of the tools utilised. The motions during the processes of fulfilling an order were identified during the case picking, bulk picking and packing processes by direct observation of operators. The direct observation was performed using a stopwatch application for Android® devices and a tool on Microsoft Excel®. The data was analysed using Microsoft Excel®, using a student’s T-test and an analysis of variance (ANOVA) approach to identify similarities and differences between the facilities. The data was further analysed using a descriptive statistics approach to identify the common barriers amongst the distribution centres. Thereafter, the data was analysed by identifying a value-quotient. The value-quotient was used to identify how much time was spent on value-adding activities with each facility. The observation of the operators was done randomly at each facility to avoid subjectivity and bias. Results: The pilot study identified which stopwatch application was to be utilised. The pilot study aided to improve upon the design of the data collection tool used for the transcribing of the timing operation. The student’s T-test and ANOVA revealed that there were statistically significant differences in case picking amongst facilities, namely using the radio frequency identification devices (RFID), picking and transfer of stock. In the bulk picking process, there was a statistically significant difference amongst the facilities, namely using the RFID, pick and transfer of stock. In the packing process there was a statistically significant difference amongst the facilities in the packing process. The analysis of barriers within the distribution centres revealed that the 16 common barriers amongst the picking processes at the facilities included raising the platform, waiting for colleagues to depart an aisle, RFID malfunctions and answering their phones. No common barriers during the packing process was identified. The value-quotient revealed that most of the facilities spent more than 50 percent of their time on value-adding activities during the case picking, bulk picking and packing processes. A time and motion analysis proved to be an effective method to identify similarities and barriers between the six facilities. It was recommended to investigate a few of the basic operations to improve upon, as well as the possibility of implementing a barcoded system to the stock.
- Full Text:
- Date Issued: 2018
Delivery of pharmaceutical services and care at three primary healthcare clinics with different dispensing models in the Nelson Mandela Bay Health District
- Authors: Bobbins, Amy Claire
- Date: 2018
- Subjects: National health insurance -- South Africa , Community health services -- South Africa Pharmaceutical services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/23580 , vital:30583
- Description: As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC.
- Full Text:
- Date Issued: 2018
- Authors: Bobbins, Amy Claire
- Date: 2018
- Subjects: National health insurance -- South Africa , Community health services -- South Africa Pharmaceutical services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/23580 , vital:30583
- Description: As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC.
- Full Text:
- Date Issued: 2018
Future role of community pharmacy in the national health insurance
- Authors: Aluko, Olubusola Aderonke
- Date: 2018
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa Community health services -- South Africa Pharmacy -- Practice -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21472 , vital:29525
- Description: Governments all over the world have shown interest in the healthcare system and various policies and measures have been adopted to ensure optimum health of the people. Inequity in health provision in South Africa is a great challenge. In South Africa, the healthcare system is currently characterised by distinctly different public and private sectors. The public sector serves approximately 84% of the population while the private sector services the smaller portion, 16% of the population. However, the expenditure in both the private and public sectors is almost the same, with approximately five times more being spent per capita in the private sector than in the public sector. The South African health care system is therefore unbalanced with respect to expenditure per capita resulting in inequitable access to, and quality of, health services. In particular, relative to the population it serves and the disease burden that it carries, the public sector is under-resourced. In order to address the inequities characteristic of the current two-tiered system, the South African Government is in the process of implementing a National Health Insurance (NHI). The NHI will provide a means of pooling all healthcare funding, thereby providing a means of cross subsidization within the public sector. Funding contributions will be linked to the ability of an individual to pay and benefits will be determined by an individual’s need for care. A core principle of NHI is to provide access to quality care. It has been suggested that within a NHI system private pharmacies may be contracted through service agreements to provide both chronic and acute medicines. However, there are currently no policies specifying the roles and functions of pharmacists in the NHI or in a re-engineered Primary Health Care system, although it has been suggested that for South Africa to have a successful healthcare system it requires the support and assistance of pharmacists. Research suggests that the majority of pharmacists do not believe that the NHI is a suitable means to address South Africa’s healthcare problems and many do not agree with the principles behind it. This study describes the perceptions and attitudes of community pharmacists and the lay public in Nelson Mandela Bay Metropole toward NHI and the potential role of community pharmacists within the NHI. A qualitative approach was used to provide an in-depth exploration of the attitudes and perceptions of community pharmacists and the lay public in Nelson Mandela Bay Metropole (NMBM). It is envisaged that this understanding will provide a basis for addressing pharmacists’ concerns and may contribute towards the further development of the role and the scope of practice of community pharmacists in the NHI. Semi-structured, in-depth interviews were conducted with both community pharmacists and with members of the public. The interviews were digitally recorded and then transcribed. The transcriptions were coded and analysed thematically. The analysis of the themes identified revealed that while community pharmacists and the public are aware of NHI they are uncertain as to how it is being implemented. However, both community pharmacists and patients see NHI as an advantage and display a positive attitude towards NHI.
- Full Text:
- Date Issued: 2018
- Authors: Aluko, Olubusola Aderonke
- Date: 2018
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa Community health services -- South Africa Pharmacy -- Practice -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21472 , vital:29525
- Description: Governments all over the world have shown interest in the healthcare system and various policies and measures have been adopted to ensure optimum health of the people. Inequity in health provision in South Africa is a great challenge. In South Africa, the healthcare system is currently characterised by distinctly different public and private sectors. The public sector serves approximately 84% of the population while the private sector services the smaller portion, 16% of the population. However, the expenditure in both the private and public sectors is almost the same, with approximately five times more being spent per capita in the private sector than in the public sector. The South African health care system is therefore unbalanced with respect to expenditure per capita resulting in inequitable access to, and quality of, health services. In particular, relative to the population it serves and the disease burden that it carries, the public sector is under-resourced. In order to address the inequities characteristic of the current two-tiered system, the South African Government is in the process of implementing a National Health Insurance (NHI). The NHI will provide a means of pooling all healthcare funding, thereby providing a means of cross subsidization within the public sector. Funding contributions will be linked to the ability of an individual to pay and benefits will be determined by an individual’s need for care. A core principle of NHI is to provide access to quality care. It has been suggested that within a NHI system private pharmacies may be contracted through service agreements to provide both chronic and acute medicines. However, there are currently no policies specifying the roles and functions of pharmacists in the NHI or in a re-engineered Primary Health Care system, although it has been suggested that for South Africa to have a successful healthcare system it requires the support and assistance of pharmacists. Research suggests that the majority of pharmacists do not believe that the NHI is a suitable means to address South Africa’s healthcare problems and many do not agree with the principles behind it. This study describes the perceptions and attitudes of community pharmacists and the lay public in Nelson Mandela Bay Metropole toward NHI and the potential role of community pharmacists within the NHI. A qualitative approach was used to provide an in-depth exploration of the attitudes and perceptions of community pharmacists and the lay public in Nelson Mandela Bay Metropole (NMBM). It is envisaged that this understanding will provide a basis for addressing pharmacists’ concerns and may contribute towards the further development of the role and the scope of practice of community pharmacists in the NHI. Semi-structured, in-depth interviews were conducted with both community pharmacists and with members of the public. The interviews were digitally recorded and then transcribed. The transcriptions were coded and analysed thematically. The analysis of the themes identified revealed that while community pharmacists and the public are aware of NHI they are uncertain as to how it is being implemented. However, both community pharmacists and patients see NHI as an advantage and display a positive attitude towards NHI.
- Full Text:
- Date Issued: 2018