Cost comparison between repackaging bulk oral solid medicines and purchasing manufacturer-prepared patient-ready packs in the public sector in South Africa
- Authors: Abahamye, Aloysius
- Date: 2014
- Subjects: Packaging -- Cost control , Business logistics -- Costs , Drugs -- Packaging , Manufacturing processes
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10163 , http://hdl.handle.net/10948/d1020596 , Drugs -- Packaging
- Description: In an attempt to have medicines available in patient-ready packs (PRPs) prior to the dispensing process, the provincial medicine depots in South Africa have, for many years, been repackaging bulk medicines into PRPs. Notwithstanding the fact that bulk medicine packages may have been the only packages available from the manufacturers to service the Primary Health Care (PHC) sector, the main aim of this process was to ensure that medicines were available in PRPs for dispensing to patients, thus, minimising the time spent on each prescription by the pharmacist, pharmacist’s assistant or Nurse. Currently, some medicines are being procured in PRPs from the manufacturers, whereas others are still procured in bulk packs which must be repackaged into PRPs. After a thorough literature search, it was established that, up until this point in time, no studies have been performed to compare costs of repackaged medicines from bulk packs with costs of medicines procured from manufacturers in PRPs. There was very scanty literature comparing the use of medicines procured either in PRPs or bulk packs. However, literature on cost comparison between repackaging and purchasing of commercially available manufacturer-prepared PRPs was not identified.
- Full Text:
- Date Issued: 2014
- Authors: Abahamye, Aloysius
- Date: 2014
- Subjects: Packaging -- Cost control , Business logistics -- Costs , Drugs -- Packaging , Manufacturing processes
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10163 , http://hdl.handle.net/10948/d1020596 , Drugs -- Packaging
- Description: In an attempt to have medicines available in patient-ready packs (PRPs) prior to the dispensing process, the provincial medicine depots in South Africa have, for many years, been repackaging bulk medicines into PRPs. Notwithstanding the fact that bulk medicine packages may have been the only packages available from the manufacturers to service the Primary Health Care (PHC) sector, the main aim of this process was to ensure that medicines were available in PRPs for dispensing to patients, thus, minimising the time spent on each prescription by the pharmacist, pharmacist’s assistant or Nurse. Currently, some medicines are being procured in PRPs from the manufacturers, whereas others are still procured in bulk packs which must be repackaged into PRPs. After a thorough literature search, it was established that, up until this point in time, no studies have been performed to compare costs of repackaged medicines from bulk packs with costs of medicines procured from manufacturers in PRPs. There was very scanty literature comparing the use of medicines procured either in PRPs or bulk packs. However, literature on cost comparison between repackaging and purchasing of commercially available manufacturer-prepared PRPs was not identified.
- Full Text:
- Date Issued: 2014
Competing interests and change within the pharmacy education system in South Africa
- Authors: Allan, Lucie
- Date: 2006
- Subjects: Pharmacy -- South Africa Pharmacy -- Study and teaching -- South Africa Pharmacy -- Practice -- South Africa Community pharmacy services -- South Africa Community health services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3741 , http://hdl.handle.net/10962/d1003219
- Description: This thesis provides a historical account of the emergence of the pharmacy education system in South Africa, and an analysis of the influence of competing interest groups over the pharmacy education curriculum. It provides a critical evaluation of structural-consensus and micro-interpretive approaches to medical and pharmacy education, and sets out a macrointerpretive account of pharmacy education in South Africa. Following Margaret Archer (1979) it analyzes three forms of negotiation between competing interest groups in their efforts to change the pharmacy curriculum; these are political manipulation, external transaction and internal initiation. The thesis argues that whilst the private sector interest group (comprising of retail, wholesale and manufacturing pharmacy) dominated the pharmacy education system until 1994, since then a newly emerged government interest group has begun to compete for educational control. The priorities pursued by this interest group have consistently reflected the objectives set out in the ANC National Health Plan of 1994. The thesis maintains that given its frustration over the non-implementation of the ANC’s health policy objectives, the government interest group is likely to resort to direct political manipulation by passing legislation to alter the content of the current pharmacy curriculum. Such changes would seek to ensure that the syllabus more accurately reflects the ANC Plan’s community health and primary health care objectives. The thesis asserts that such an outcome (of direct political manipulation of the curriculum) is not inevitable, and can be avoided through a process of internally initiated change. It presents the findings of an interpretive case study into how the Rhodes University Community Experience Programme (CEP) influenced final year pharmacy students’ perceptions of the role of the pharmacist. The students’ comments were collected by means of focus group interviews, participant observation and documentary analysis. Whilst the CEP did not successfully transform their concept of the pharmacist’s role, it did succeed in influencing students’ understanding of the notions of community pharmacy and primary health care in line with the government interest group’s health objectives. This thesis concludes that internally initiated change within the pharmacy education system, would be preferable to that imposed through external political manipulation, as such change would be more likely to preserve the independent professional interests of pharmacy academics.
- Full Text:
- Date Issued: 2006
- Authors: Allan, Lucie
- Date: 2006
- Subjects: Pharmacy -- South Africa Pharmacy -- Study and teaching -- South Africa Pharmacy -- Practice -- South Africa Community pharmacy services -- South Africa Community health services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3741 , http://hdl.handle.net/10962/d1003219
- Description: This thesis provides a historical account of the emergence of the pharmacy education system in South Africa, and an analysis of the influence of competing interest groups over the pharmacy education curriculum. It provides a critical evaluation of structural-consensus and micro-interpretive approaches to medical and pharmacy education, and sets out a macrointerpretive account of pharmacy education in South Africa. Following Margaret Archer (1979) it analyzes three forms of negotiation between competing interest groups in their efforts to change the pharmacy curriculum; these are political manipulation, external transaction and internal initiation. The thesis argues that whilst the private sector interest group (comprising of retail, wholesale and manufacturing pharmacy) dominated the pharmacy education system until 1994, since then a newly emerged government interest group has begun to compete for educational control. The priorities pursued by this interest group have consistently reflected the objectives set out in the ANC National Health Plan of 1994. The thesis maintains that given its frustration over the non-implementation of the ANC’s health policy objectives, the government interest group is likely to resort to direct political manipulation by passing legislation to alter the content of the current pharmacy curriculum. Such changes would seek to ensure that the syllabus more accurately reflects the ANC Plan’s community health and primary health care objectives. The thesis asserts that such an outcome (of direct political manipulation of the curriculum) is not inevitable, and can be avoided through a process of internally initiated change. It presents the findings of an interpretive case study into how the Rhodes University Community Experience Programme (CEP) influenced final year pharmacy students’ perceptions of the role of the pharmacist. The students’ comments were collected by means of focus group interviews, participant observation and documentary analysis. Whilst the CEP did not successfully transform their concept of the pharmacist’s role, it did succeed in influencing students’ understanding of the notions of community pharmacy and primary health care in line with the government interest group’s health objectives. This thesis concludes that internally initiated change within the pharmacy education system, would be preferable to that imposed through external political manipulation, as such change would be more likely to preserve the independent professional interests of pharmacy academics.
- Full Text:
- Date Issued: 2006
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
Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
- Date Issued: 2012
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
- Date Issued: 2012
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
A drug utilisation review of Isotretinoin in the management of acne
- Authors: Burger, Solé
- Date: 2007
- Subjects: Acne -- Treatment , Isotretinoin
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10147 , http://hdl.handle.net/10948/673 , Acne -- Treatment , Isotretinoin
- Description: Acne is a common, chronic disorder that affects many adolescents. The most effective acne medication is systemic isotretinoin. It provides a permanent cure for many patients, but has various side effects. A South African Acne Treatment Guideline was introduced in 2005. Adherence to this guideline could lead to safer, more effective acne management. The primary aim of this study was to investigate the appropriateness of medications prescribed in the treatment of acne in South Africa, and to evaluate the safety and efficacy of systemic isotretinoin utilised by patients in the Nelson Mandela Metropole (NMM). A drug utilisation study (including 18 803 South African acne patients’ chronic prescription data between 2000 and 2005) and a patient questionnaire survey (including information from 57 patients in the NMM who used systemic isotretinoin) were conducted. Basic descriptive and interferential statistics were calculated. The drug utilisation study revealed that systemic antibiotics were the acne treatment prescribed to most (43.3 percent) patients, followed by 42.1 percent of patients on systemic isotretinoin, 33.2 percent on hormonal therapy and 18.9 percent on topical therapy. Topical retinoids were underused. The questionnaire survey indicated a lack of compliance by prescribers with guideline recommendations regarding the prescription (and accompanying counselling and monitoring) of isotretinoin. Incorrect cumulative doses were frequently prescribed, and a lack of proper implementation of pregnancy prevention measures was evident. The majority of isotretinoin patients reported a high efficacy of isotretinoin in clearing their acne.
- Full Text:
- Date Issued: 2007
- Authors: Burger, Solé
- Date: 2007
- Subjects: Acne -- Treatment , Isotretinoin
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10147 , http://hdl.handle.net/10948/673 , Acne -- Treatment , Isotretinoin
- Description: Acne is a common, chronic disorder that affects many adolescents. The most effective acne medication is systemic isotretinoin. It provides a permanent cure for many patients, but has various side effects. A South African Acne Treatment Guideline was introduced in 2005. Adherence to this guideline could lead to safer, more effective acne management. The primary aim of this study was to investigate the appropriateness of medications prescribed in the treatment of acne in South Africa, and to evaluate the safety and efficacy of systemic isotretinoin utilised by patients in the Nelson Mandela Metropole (NMM). A drug utilisation study (including 18 803 South African acne patients’ chronic prescription data between 2000 and 2005) and a patient questionnaire survey (including information from 57 patients in the NMM who used systemic isotretinoin) were conducted. Basic descriptive and interferential statistics were calculated. The drug utilisation study revealed that systemic antibiotics were the acne treatment prescribed to most (43.3 percent) patients, followed by 42.1 percent of patients on systemic isotretinoin, 33.2 percent on hormonal therapy and 18.9 percent on topical therapy. Topical retinoids were underused. The questionnaire survey indicated a lack of compliance by prescribers with guideline recommendations regarding the prescription (and accompanying counselling and monitoring) of isotretinoin. Incorrect cumulative doses were frequently prescribed, and a lack of proper implementation of pregnancy prevention measures was evident. The majority of isotretinoin patients reported a high efficacy of isotretinoin in clearing their acne.
- Full Text:
- Date Issued: 2007
Development and implementation of health promotion activities for the prevention of adolescent pregnancies
- Authors: Chemuru, Nomsa Rutendo
- Date: 2017
- Subjects: Teenage pregnancy -- South Africa -- Makhanda , Teenage pregnancy -- Prevention -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/5115 , vital:20776
- Description: Of the eight Millennium Development Goals (MDGs) established in 2000 by the World Health Organisation, Millennium Development Goals 5 aimed at improving maternal health by addressing the high maternal mortality rate and increasing universal access to reproductive health by 2015.Adolescent pregnancy contributes to maternal, perinatal and infant mortality and also worsens the empowerment of young girls by negatively affecting their physical, educational, social, and economic development.This is a pressing public health concern in South Africa. The reduction of adolescent pregnancy is vital for achieving the sustainable human, health social and economic development of society at large. Culturally sensitive interventions to prevent adolescent pregnancies not only integrate the communities' norms, values, practices and behavioural patterns into the intervention's design and implementation but also the historical, social and economic contexts in which they exist. Progress has been made on the research on health promotion and education in South Africa; however communities are often not consulted on the design and conduct of health promotion research projects.The aim of the study was to develop and implement culturally sensitive and appropriate health promotion activities for the prevention of adolescent pregnancy in Grahamstown, Glenmore and Ndwayana communities in the Eastern Cape, South Africa.Two community based organisations and community care workers associated with them participated in this Community Based Participatory Research using the PEN-3 cultural model. The first phase of this study involved semi-structured interviews carried out with 14 community care workers to identify factors and consequences of adolescent pregnancies in their respective communities. The audio-recorded interviews were transcribed and coded using NVivo® 2010 software. The PEN 3 cultural model was adopted in the studyto address the socio-cultural factors contributing to adolescent pregnancy in the communities. The second phase involved a series of interactive workshops with CCWs for a participatory development of the facilitator's manual. Responses from CCWs informed the design of this study's intervention strategies. A facilitator's manual was developed to implement health promotion intervention, leading to the third phase of this study. The guided implementationof the health promotion intervention for the prevention of adolescent pregnancy was carried out over a period of 14 months and evaluated in the final phase of the study. The facilitator's manual was modified based on feedback fromCCWs, on possible improvements and cultural appropriateness. Readability testing guided the final modification of the manual. According to the community care workers, there were a number of adolescents who fell pregnant in their communities each year. The CCWs identified the influence of family members, friends and other stakeholders as contributory factors to adolescent pregnancy. They identified the lack of parental support in informing and educating adolescents about sexual health. Adolescents themselves lacked the maturity to recognise the risks and consequences of adolescent pregnancy. The negative perceptions of contraception in the community were discouraging contraceptive use amongst the adolescents. However, the results showed that enablers such as home and school visits done by the community care workers can be utilised to prevent adolescent pregnancy. Other factors included lack of health promotion materials and activities with information about preventing of adolescent pregnancy, and if available, the material is in English, that the adolescents may not comprehend. Socio-economic factors such as poverty, the Child Support Grant, cross generational relationships and coerced sex further contributed to adolescent pregnancy in the communities.CCWs identified the need for a more comprehensive health promotion intervention to prevent of adolescent pregnancy. A facilitator's manual addressing the prevention of adolescent pregnancy was developed and modified through a series participatory workshops with the community care workers.The facilitator's manual was used by CCWs to conducthealth promotion activities encouraging the prevention of adolescent pregnancies within the community's clinics, schools and during home visits. Community based participatory research methods and the PEN-3cultural model were used to develop this culturally sensitive and community specific adolescent pregnancy intervention for and by the CCWs. The participatory development of the facilitator's manual and the regular interactive workshops with the CCWs were strengthened by embedding this project into the development programs of the two non-governmental organisations contributing to sustainable development programs for women and children.
- Full Text:
- Date Issued: 2017
- Authors: Chemuru, Nomsa Rutendo
- Date: 2017
- Subjects: Teenage pregnancy -- South Africa -- Makhanda , Teenage pregnancy -- Prevention -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/5115 , vital:20776
- Description: Of the eight Millennium Development Goals (MDGs) established in 2000 by the World Health Organisation, Millennium Development Goals 5 aimed at improving maternal health by addressing the high maternal mortality rate and increasing universal access to reproductive health by 2015.Adolescent pregnancy contributes to maternal, perinatal and infant mortality and also worsens the empowerment of young girls by negatively affecting their physical, educational, social, and economic development.This is a pressing public health concern in South Africa. The reduction of adolescent pregnancy is vital for achieving the sustainable human, health social and economic development of society at large. Culturally sensitive interventions to prevent adolescent pregnancies not only integrate the communities' norms, values, practices and behavioural patterns into the intervention's design and implementation but also the historical, social and economic contexts in which they exist. Progress has been made on the research on health promotion and education in South Africa; however communities are often not consulted on the design and conduct of health promotion research projects.The aim of the study was to develop and implement culturally sensitive and appropriate health promotion activities for the prevention of adolescent pregnancy in Grahamstown, Glenmore and Ndwayana communities in the Eastern Cape, South Africa.Two community based organisations and community care workers associated with them participated in this Community Based Participatory Research using the PEN-3 cultural model. The first phase of this study involved semi-structured interviews carried out with 14 community care workers to identify factors and consequences of adolescent pregnancies in their respective communities. The audio-recorded interviews were transcribed and coded using NVivo® 2010 software. The PEN 3 cultural model was adopted in the studyto address the socio-cultural factors contributing to adolescent pregnancy in the communities. The second phase involved a series of interactive workshops with CCWs for a participatory development of the facilitator's manual. Responses from CCWs informed the design of this study's intervention strategies. A facilitator's manual was developed to implement health promotion intervention, leading to the third phase of this study. The guided implementationof the health promotion intervention for the prevention of adolescent pregnancy was carried out over a period of 14 months and evaluated in the final phase of the study. The facilitator's manual was modified based on feedback fromCCWs, on possible improvements and cultural appropriateness. Readability testing guided the final modification of the manual. According to the community care workers, there were a number of adolescents who fell pregnant in their communities each year. The CCWs identified the influence of family members, friends and other stakeholders as contributory factors to adolescent pregnancy. They identified the lack of parental support in informing and educating adolescents about sexual health. Adolescents themselves lacked the maturity to recognise the risks and consequences of adolescent pregnancy. The negative perceptions of contraception in the community were discouraging contraceptive use amongst the adolescents. However, the results showed that enablers such as home and school visits done by the community care workers can be utilised to prevent adolescent pregnancy. Other factors included lack of health promotion materials and activities with information about preventing of adolescent pregnancy, and if available, the material is in English, that the adolescents may not comprehend. Socio-economic factors such as poverty, the Child Support Grant, cross generational relationships and coerced sex further contributed to adolescent pregnancy in the communities.CCWs identified the need for a more comprehensive health promotion intervention to prevent of adolescent pregnancy. A facilitator's manual addressing the prevention of adolescent pregnancy was developed and modified through a series participatory workshops with the community care workers.The facilitator's manual was used by CCWs to conducthealth promotion activities encouraging the prevention of adolescent pregnancies within the community's clinics, schools and during home visits. Community based participatory research methods and the PEN-3cultural model were used to develop this culturally sensitive and community specific adolescent pregnancy intervention for and by the CCWs. The participatory development of the facilitator's manual and the regular interactive workshops with the CCWs were strengthened by embedding this project into the development programs of the two non-governmental organisations contributing to sustainable development programs for women and children.
- Full Text:
- Date Issued: 2017
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
Workplace health promotion: a case of Rhodes University support staff
- Chigumete, Tinatsei Gabriella
- Authors: Chigumete, Tinatsei Gabriella
- Date: 2017
- Subjects: Rhodes University -- Employees -- Health and hygiene , Employee health promotion -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44509 , vital:25414
- Description: Background: Non-communicable diseases are rapidly advancing as leading causes of morbidity and mortality across social classes, exerting pressure on existing financial, organizational, and human resources. Health promotion is a common practice in the prevention of noncommunicable diseases, 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 take into consideration when planning future initiatives. Well-informed and guided workplace health promotion initiatives are essential to improve the general health of staff, and these also need to take the broader cultural, socioeconomic, and environmental factors influencing non-communicable diseases in the target population into account. This two-phase study was conducted at Rhodes University. A needs assessment was conducted to identify current policies and practices of workplace health promotion and to identify any shortcomings of the initiatives that have previously been attempted to raise awareness of non-communicable diseases at Rhodes University. 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 noncommunicable diseases through heart healthy diets and physical activity. Method: The first phase of the current study involved working with the support staff and key stakeholders. Using the participatory action research approach and the PRECEDE-PROCEED model to guide the research, 11 semi-structured interviews with key stakeholders and 10 focus group discussions were conducted with support staff members to identify factors affecting workplace health promotion. Participant 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 support staff members who volunteered their involvement in the design and delivery of the educational intervention was also identified. They chose to go by the name, the Health Awareness Group.In an interim phase of the study, three health information leaflets informed by the results from the above activities were designed. These leaflets underwent a series of qualitative evaluations by other health professionals, a culture and African languages expert, and the Health Awareness Group, to assess content validity, context specificity, and cultural appropriateness for the target group. A series of quantitative tests for readability, suitability, and actionability was also conducted. The health information leaflets were then used as written materials in the educational intervention of the project. Members of the Health Awareness Group were also trained as peer educators through a series of workshops. This enabled them to promote and raise awareness of heart healthy diets and physical activity to others in the workplace. Workshops were participatory in nature and were guided by the Social Cognitive Theory. They 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 the turnout was poor and most staff did not seem to understand the health benefits of these initiatives. The support staff, in turn, stated that most health talks were conducted in English, contained medical jargon, and that they would have preferred these initiatives either to be simplified or presented in their home language, and to display cultural sensitivity. Support staff have also reported that advertisements were too cliche to elicit their interest. They also suggested incentivising initiatives for better participation. Another key suggestion was to facilitate these initiatives in the university departments they work or other convenient venues, rather than at central venues. It was also suggested that these initiatives be part of the work calendar, as they are often 'impromptu' and, as a result, staff members did not have enough notice to take time off work. Several staff members requested 're-runs of these initiatives because one-time show cases are often inadequate'. Colourful visual representations on posters or leaflets, short plays or films 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. Members of the Health Awareness Group 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 support staff, health promotion policies and protocols for non-communicable diseases have not yet been developed. Health promotion initiatives, especially for support staff, that address non-communicable diseases have previously been attempted at the university but were not well-received. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful in designing and tailoring the written educational materials and the educational intervention to the needs of the support staff and to redress the deficiencies of previous initiatives. The health leaflets were deemed appropriate for use by the target population. They addressed pertinent information needs. The health information leaflets and workshops were useful in equipping the Health Awareness Group with knowledge on heart healthy diets and promotion of physical activity. Continued the involvement of representatives from the Human Resources and Wellness offices will assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2017
- Authors: Chigumete, Tinatsei Gabriella
- Date: 2017
- Subjects: Rhodes University -- Employees -- Health and hygiene , Employee health promotion -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44509 , vital:25414
- Description: Background: Non-communicable diseases are rapidly advancing as leading causes of morbidity and mortality across social classes, exerting pressure on existing financial, organizational, and human resources. Health promotion is a common practice in the prevention of noncommunicable diseases, 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 take into consideration when planning future initiatives. Well-informed and guided workplace health promotion initiatives are essential to improve the general health of staff, and these also need to take the broader cultural, socioeconomic, and environmental factors influencing non-communicable diseases in the target population into account. This two-phase study was conducted at Rhodes University. A needs assessment was conducted to identify current policies and practices of workplace health promotion and to identify any shortcomings of the initiatives that have previously been attempted to raise awareness of non-communicable diseases at Rhodes University. 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 noncommunicable diseases through heart healthy diets and physical activity. Method: The first phase of the current study involved working with the support staff and key stakeholders. Using the participatory action research approach and the PRECEDE-PROCEED model to guide the research, 11 semi-structured interviews with key stakeholders and 10 focus group discussions were conducted with support staff members to identify factors affecting workplace health promotion. Participant 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 support staff members who volunteered their involvement in the design and delivery of the educational intervention was also identified. They chose to go by the name, the Health Awareness Group.In an interim phase of the study, three health information leaflets informed by the results from the above activities were designed. These leaflets underwent a series of qualitative evaluations by other health professionals, a culture and African languages expert, and the Health Awareness Group, to assess content validity, context specificity, and cultural appropriateness for the target group. A series of quantitative tests for readability, suitability, and actionability was also conducted. The health information leaflets were then used as written materials in the educational intervention of the project. Members of the Health Awareness Group were also trained as peer educators through a series of workshops. This enabled them to promote and raise awareness of heart healthy diets and physical activity to others in the workplace. Workshops were participatory in nature and were guided by the Social Cognitive Theory. They 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 the turnout was poor and most staff did not seem to understand the health benefits of these initiatives. The support staff, in turn, stated that most health talks were conducted in English, contained medical jargon, and that they would have preferred these initiatives either to be simplified or presented in their home language, and to display cultural sensitivity. Support staff have also reported that advertisements were too cliche to elicit their interest. They also suggested incentivising initiatives for better participation. Another key suggestion was to facilitate these initiatives in the university departments they work or other convenient venues, rather than at central venues. It was also suggested that these initiatives be part of the work calendar, as they are often 'impromptu' and, as a result, staff members did not have enough notice to take time off work. Several staff members requested 're-runs of these initiatives because one-time show cases are often inadequate'. Colourful visual representations on posters or leaflets, short plays or films 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. Members of the Health Awareness Group 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 support staff, health promotion policies and protocols for non-communicable diseases have not yet been developed. Health promotion initiatives, especially for support staff, that address non-communicable diseases have previously been attempted at the university but were not well-received. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful in designing and tailoring the written educational materials and the educational intervention to the needs of the support staff and to redress the deficiencies of previous initiatives. The health leaflets were deemed appropriate for use by the target population. They addressed pertinent information needs. The health information leaflets and workshops were useful in equipping the Health Awareness Group with knowledge on heart healthy diets and promotion of physical activity. Continued the involvement of representatives from the Human Resources and Wellness offices will assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2017
Microbial water quality monitoring of raw and treated water sources in Harare and the effect of gender in disaster management due to water related disasters
- Authors: Chirenda, Tatenda Grace
- Date: 2017
- Subjects: Drinking water Microbiology Zimbabwe Harare , Heterotrophic bacteria Zimbabwe Harare , Emergency management Zimbabwe Harare , Disasters Social aspects Zimbabwe Harare , Water quality management Zimbabwe Harare , Public health Zimbabwe Harare , Sex role Zimbabwe Harare
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/59156 , vital:27444
- Description: Background - Microbial water quality monitoring is essential to the provision of potable water for domestic use. Unsafe water sources increase the risk of waterborne diseases. There is a need to raise awareness of legislature that supports management of water related disasters. Gender, education, health, and economic vulnerability contribute to the success of disaster management. Aim - This study aimed to investigate the microbial water quality of treated water in the Harare area. The study also researched the microbial water quality monitoring practices in Zimbabwe and how these contribute to the management of water borne diseases. The impact of gender, marriage, education, and disease in disaster management practices in Zimbabwe and South Africa was analysed. Method - Literature review was conducted on microbial water quality monitoring practices in Zimbabwe and legislature that supports disaster management. Practices of disaster management in Zimbabwe, and South Africa were investigated and compared. The perspective of the Harare community on the quality of their potable water was investigated through the use of a questionnaire and water quality testing was conducted using hydrogen sulphide test and R2A based heterotrophic plate count. Raw water supplying Manyame River and tap water in Harare households were assessed for microbial quality. Results and Discussion - Raw water sources were found to be contaminated by faecal matter. Household water sources had no faecal contamination, but tested positive for heterotrophic bacteria. The CFU/ml quantities obtained ranged from 1- 452 CFU/ml for all samples. The WHO guidelines for domestic water sources recommend that domestic water should have no coliforms/100 ml sample. Disaster management protocols were available in disaster prone areas such as the Matabeleland South Province. No guidelines were in place for monitoring microbial water quality as a disaster prevention method. Conclusion - The current state of treated water supplied by the Morton Jaffray Treatment Plant was found to be suitable for domestic use, but not sufficient to meet the Harare population’s needs. The need to push for legislature supporting microbial water quality monitoring was recognised. Initiating public / private partnerships in water distribution and water quality monitoring in Zimbabwe was encouraged.
- Full Text:
- Date Issued: 2017
- Authors: Chirenda, Tatenda Grace
- Date: 2017
- Subjects: Drinking water Microbiology Zimbabwe Harare , Heterotrophic bacteria Zimbabwe Harare , Emergency management Zimbabwe Harare , Disasters Social aspects Zimbabwe Harare , Water quality management Zimbabwe Harare , Public health Zimbabwe Harare , Sex role Zimbabwe Harare
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/59156 , vital:27444
- Description: Background - Microbial water quality monitoring is essential to the provision of potable water for domestic use. Unsafe water sources increase the risk of waterborne diseases. There is a need to raise awareness of legislature that supports management of water related disasters. Gender, education, health, and economic vulnerability contribute to the success of disaster management. Aim - This study aimed to investigate the microbial water quality of treated water in the Harare area. The study also researched the microbial water quality monitoring practices in Zimbabwe and how these contribute to the management of water borne diseases. The impact of gender, marriage, education, and disease in disaster management practices in Zimbabwe and South Africa was analysed. Method - Literature review was conducted on microbial water quality monitoring practices in Zimbabwe and legislature that supports disaster management. Practices of disaster management in Zimbabwe, and South Africa were investigated and compared. The perspective of the Harare community on the quality of their potable water was investigated through the use of a questionnaire and water quality testing was conducted using hydrogen sulphide test and R2A based heterotrophic plate count. Raw water supplying Manyame River and tap water in Harare households were assessed for microbial quality. Results and Discussion - Raw water sources were found to be contaminated by faecal matter. Household water sources had no faecal contamination, but tested positive for heterotrophic bacteria. The CFU/ml quantities obtained ranged from 1- 452 CFU/ml for all samples. The WHO guidelines for domestic water sources recommend that domestic water should have no coliforms/100 ml sample. Disaster management protocols were available in disaster prone areas such as the Matabeleland South Province. No guidelines were in place for monitoring microbial water quality as a disaster prevention method. Conclusion - The current state of treated water supplied by the Morton Jaffray Treatment Plant was found to be suitable for domestic use, but not sufficient to meet the Harare population’s needs. The need to push for legislature supporting microbial water quality monitoring was recognised. Initiating public / private partnerships in water distribution and water quality monitoring in Zimbabwe was encouraged.
- Full Text:
- Date Issued: 2017
Evaluation of the acceptability of ambulatory blood pressure monitoring in a semi-rural, Eastern Cape population
- Authors: Chiwanza, Farisai
- Date: 2017
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/59161 , vital:27447
- Description: Expected release date-April 2019
- Full Text:
- Date Issued: 2017
- Authors: Chiwanza, Farisai
- Date: 2017
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/59161 , vital:27447
- Description: Expected release date-April 2019
- Full Text:
- Date Issued: 2017
The impact of HAART on sexuality and medicine taking behaviours among people living with HIV/AIDS in Grahamstown
- Authors: Chizanga, Tongai Aldridge
- Date: 2010
- Subjects: AIDS (Disease) -- Treatment -- South Africa -- Grahamstown HIV infections -- Treatment -- South Africa -- Grahamstown Antiretroviral agents -- South Africa -- Grahamstown Patient compliance -- South Africa -- Grahamstown AIDS (Disease) -- Social aspects -- South Africa -- Grahamstown HIV infections -- Social aspects -- South Africa -- Grahamstown AIDS (Disease) -- Patients -- South Africa -- Grahamstown -- Sexual behavior HIV-positive persons -- South Africa -- Grahamstown -- Sexual behavior Patient education -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3750 , http://hdl.handle.net/10962/d1003228
- Description: Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.
- Full Text:
- Date Issued: 2010
- Authors: Chizanga, Tongai Aldridge
- Date: 2010
- Subjects: AIDS (Disease) -- Treatment -- South Africa -- Grahamstown HIV infections -- Treatment -- South Africa -- Grahamstown Antiretroviral agents -- South Africa -- Grahamstown Patient compliance -- South Africa -- Grahamstown AIDS (Disease) -- Social aspects -- South Africa -- Grahamstown HIV infections -- Social aspects -- South Africa -- Grahamstown AIDS (Disease) -- Patients -- South Africa -- Grahamstown -- Sexual behavior HIV-positive persons -- South Africa -- Grahamstown -- Sexual behavior Patient education -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3750 , http://hdl.handle.net/10962/d1003228
- Description: Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.
- Full Text:
- Date Issued: 2010
Medication errors in a private hospital closed intensive care unit: a retrospective analysis of process change
- Authors: Cruickshank, Deborah Claire
- Date: 2017
- Subjects: Medication errors
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/15501 , vital:28259
- Description: Healthcare professionals should be concerned about the safety of the patients in their care and the references to patient safety go back as far as the Hippocratic Oath. Study of literature however shows that medical errors are still of concern and the majority of medical errors are medication errors. The aim of the study was to determine whether process changes introduced reduced both the medication prescribing and medication administration errors in the intensive care unit, thereby contributing to an increase in overall patient safety in the intensive care unit. This study retrospectively analysed the effect of the process changes on medication prescribing and administration errors. The research objectives were to: Identify the number and type of prescribing medication errors prior to the implementation of process changes; Identify the number and type of administration medication errors prior to the implementation of process changes; Identify the process changes implemented; o Determine number and type of prescribing medication errors post the implementation of process changes; Determine number and type of administration medication errors post the implementation of process changes; Assess whether the process changes affected the number and type of prescribing medication errors; and o Assess whether the process changes affected the number and type of administration medication errors. In the Phase One (1 November 2013 to 31 January 2014) 534 patient prescription charts for 172 patients were examined. Medication error rates of 57.6% (n=99) of individual patients reviewed and 18.4% of total patient prescription charts reviewed were found. A total of 69 medication prescribing errors were found in Phase One. This equates to an error percentage of 12.9% per patient chart reviewed and 40.1% per patient reviewed. Thirty medication administration errors were identified in Phase One of the study representing 17.4% of patients reviewed and 5.6% of patient prescription charts reviewed. Medication administration errors included both errors of commission, incorrect doses administered, (n=19) and omission, dose missed, (n=11). Process changes were then introduced and the results of these changes analysed in Phase Two (1 April 2014 to 31 December 2014) show an overall reduction in total medication errors with relation to number of patients reviewed from 57.6% in Phase One to 40.5% in Phase Two. In relation to number of prescription charts reviewed the medication error rate in Phase One was 18.4% and in Phase Two 14.4%. Prescribing errors in relation to number of patients reviewed reduced from 40.1% in Phase One to 26.19% in Phase Two. Overall reductions in percentage of errors were seen in all categories of prescribing errors except duplication of therapy which showed a slight increase. Based on the number of patients reviewed a reduction of prescribing errors was seen in the following categories: transcription errors (13.3% to 7.6%), anticoagulant not prescribed when indicated (3.5% to 2.4%), medication safety (5.2% to 2.9%), dose errors (9.3% to 6.6%) and duration of therapy (6.3% to 3.6%). An increase in the duplication of therapy error rate was seen (2.3% to 3.1%). There was also a reduction in administration errors in relation to number of patients reviewed with a total number of errors of 17.4% in Phase One and 15.8% in Phase Two. The number of prescribing errors per medication chart in Phase Two showed a statistically significant reduction (p=.002). A statistically significant reduction was also seen when the number of errors per patient was reviewed (p=.008). The total number of medication administration errors per medication chart showed a significant reduction (p=.042) as did the number of administration errors per patient (p=.003). When combining the total number of medication errors (both prescriobing and administration) a significant reduction was seen for both the number of charts reviewed (p=.001) and the number of patients reviewed (p=.002). These results indicate that the desired goal of increasing patient safety with regard to medication errors has been achieved but ongoing study is required to ensure the sustainability of the process changes.
- Full Text:
- Date Issued: 2017
- Authors: Cruickshank, Deborah Claire
- Date: 2017
- Subjects: Medication errors
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/15501 , vital:28259
- Description: Healthcare professionals should be concerned about the safety of the patients in their care and the references to patient safety go back as far as the Hippocratic Oath. Study of literature however shows that medical errors are still of concern and the majority of medical errors are medication errors. The aim of the study was to determine whether process changes introduced reduced both the medication prescribing and medication administration errors in the intensive care unit, thereby contributing to an increase in overall patient safety in the intensive care unit. This study retrospectively analysed the effect of the process changes on medication prescribing and administration errors. The research objectives were to: Identify the number and type of prescribing medication errors prior to the implementation of process changes; Identify the number and type of administration medication errors prior to the implementation of process changes; Identify the process changes implemented; o Determine number and type of prescribing medication errors post the implementation of process changes; Determine number and type of administration medication errors post the implementation of process changes; Assess whether the process changes affected the number and type of prescribing medication errors; and o Assess whether the process changes affected the number and type of administration medication errors. In the Phase One (1 November 2013 to 31 January 2014) 534 patient prescription charts for 172 patients were examined. Medication error rates of 57.6% (n=99) of individual patients reviewed and 18.4% of total patient prescription charts reviewed were found. A total of 69 medication prescribing errors were found in Phase One. This equates to an error percentage of 12.9% per patient chart reviewed and 40.1% per patient reviewed. Thirty medication administration errors were identified in Phase One of the study representing 17.4% of patients reviewed and 5.6% of patient prescription charts reviewed. Medication administration errors included both errors of commission, incorrect doses administered, (n=19) and omission, dose missed, (n=11). Process changes were then introduced and the results of these changes analysed in Phase Two (1 April 2014 to 31 December 2014) show an overall reduction in total medication errors with relation to number of patients reviewed from 57.6% in Phase One to 40.5% in Phase Two. In relation to number of prescription charts reviewed the medication error rate in Phase One was 18.4% and in Phase Two 14.4%. Prescribing errors in relation to number of patients reviewed reduced from 40.1% in Phase One to 26.19% in Phase Two. Overall reductions in percentage of errors were seen in all categories of prescribing errors except duplication of therapy which showed a slight increase. Based on the number of patients reviewed a reduction of prescribing errors was seen in the following categories: transcription errors (13.3% to 7.6%), anticoagulant not prescribed when indicated (3.5% to 2.4%), medication safety (5.2% to 2.9%), dose errors (9.3% to 6.6%) and duration of therapy (6.3% to 3.6%). An increase in the duplication of therapy error rate was seen (2.3% to 3.1%). There was also a reduction in administration errors in relation to number of patients reviewed with a total number of errors of 17.4% in Phase One and 15.8% in Phase Two. The number of prescribing errors per medication chart in Phase Two showed a statistically significant reduction (p=.002). A statistically significant reduction was also seen when the number of errors per patient was reviewed (p=.008). The total number of medication administration errors per medication chart showed a significant reduction (p=.042) as did the number of administration errors per patient (p=.003). When combining the total number of medication errors (both prescriobing and administration) a significant reduction was seen for both the number of charts reviewed (p=.001) and the number of patients reviewed (p=.002). These results indicate that the desired goal of increasing patient safety with regard to medication errors has been achieved but ongoing study is required to ensure the sustainability of the process changes.
- Full Text:
- Date Issued: 2017
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
Optimisation of pharmacological management of diabetes mellitus in a primary health care setting
- Authors: Dickason, Beverley Janine
- Date: 2007
- Subjects: Diabetes , Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10161 , http://hdl.handle.net/10948/846 , http://hdl.handle.net/10948/d1012902 , Diabetes , Diabetes -- Treatment
- Description: Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
- Full Text:
- Date Issued: 2007
- Authors: Dickason, Beverley Janine
- Date: 2007
- Subjects: Diabetes , Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10161 , http://hdl.handle.net/10948/846 , http://hdl.handle.net/10948/d1012902 , Diabetes , Diabetes -- Treatment
- Description: Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
- Full Text:
- Date Issued: 2007
Method validation for the quantification of casticin in vitex agnus castus fruit using an ftir multivariate chemometric model
- Authors: Du Toit Louw, Philippus
- Date: 2018
- Subjects: Drugs -- Analysis -- Methodology -- Evaluation , Alternative medicine -- Research , Liquid chromatography
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30917 , vital:31222
- Description: The Complementary and Alternative Medicines (CAMS) and dietary supplement industry is an R8.84 billion a year industry in South Africa, with the sector expected to grow 12% annually. The industry has largely been unregulated up until 15 November 2013, when the South African government amended the Medicines and Related Substance Control Act (Act 101 of 1965) to include the definition of “Complementary Medicines” and “Health Supplements”. The emphasis of the new regulations is largely on the quality and safety of CAMS products. Manufacturers therefore need to demonstrate that the active ingredients used in manufacturing will be of an appropriate and consistent quality. The research question therefore is: Can a chemometric multivariate model be used to develop a rapid, cost effective method to quantify casticin, the major chemical constituent of Vitex agnus-castus (VAC) that can be used during routine quality control procedures? The primary aim of this study was to prepare a validated method using fourier transform infrared spectroscopy (FTIR) to quantify the casticin content in VAC fruit. The results from the HPLC analysis were as follows; the penduletin eluted at a retention time of 12.419 ± 0.376 minutes. The casticin eluted at a retention time of 12.943 ± 0.018 minutes. The casticin content for the samples ranged from 0.0115 – 0.0147% m/m casticin content with an average of 0.0134%. This is well below the pharmacopoeia requirement of not less than (NLT) 0.08% casticin content as described in the British Pharmacopoeia (BP). The results obtained from the HPLC analysis were used to construct the FTIR calibration model. The calibration model consisted of 18 spectra with 530 selected data points. The model was specific for casticin as spectral regions in the calibration model can be correlated to a known IR spectral response associated with the carbonyl group of casticin. The calibration equation in the xii form of % m/m casticin content had a coefficient of determination (R2) value of 0.9855 and a root mean square error of cross-validation (RMSECV) of 0.000119. The accuracy of the model had recoveries of between 98 - 102% for the actual vs true prediction. The percentage relative standard deviation (%RSD) between nine repeated measurements was 3.46%, this does not meet the International Conference of Harmonisation (ICH) requirement for precision of not more than (NMT) 2% RSD. The range of the calibration model was between 0.01147 and 0.01469 % m/m casticin content as established by the calibration model. The robustness of the method was assessed by challenging the model with samples that fall outside of the concentration of range of the model. This was established by quantifying previously scanned samples of VAC that is not part of the calibration set. The model was able to verify if the tested samples prediction was outside of the validated calibration range. The method was subsequently also challenged with a sample of a different identity to VAC. The model indicated that the sample tested does not fall in the range of the method and was clearly recognised as an outlier. The method was rapid and does not require any expensive solvents or timeconsuming sample preparation. However, the method does not meet the ICH requirements for method validation, the method does show potential and further method development and expansion of the calibration model can ensure that the method be validated.
- Full Text:
- Date Issued: 2018
- Authors: Du Toit Louw, Philippus
- Date: 2018
- Subjects: Drugs -- Analysis -- Methodology -- Evaluation , Alternative medicine -- Research , Liquid chromatography
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/30917 , vital:31222
- Description: The Complementary and Alternative Medicines (CAMS) and dietary supplement industry is an R8.84 billion a year industry in South Africa, with the sector expected to grow 12% annually. The industry has largely been unregulated up until 15 November 2013, when the South African government amended the Medicines and Related Substance Control Act (Act 101 of 1965) to include the definition of “Complementary Medicines” and “Health Supplements”. The emphasis of the new regulations is largely on the quality and safety of CAMS products. Manufacturers therefore need to demonstrate that the active ingredients used in manufacturing will be of an appropriate and consistent quality. The research question therefore is: Can a chemometric multivariate model be used to develop a rapid, cost effective method to quantify casticin, the major chemical constituent of Vitex agnus-castus (VAC) that can be used during routine quality control procedures? The primary aim of this study was to prepare a validated method using fourier transform infrared spectroscopy (FTIR) to quantify the casticin content in VAC fruit. The results from the HPLC analysis were as follows; the penduletin eluted at a retention time of 12.419 ± 0.376 minutes. The casticin eluted at a retention time of 12.943 ± 0.018 minutes. The casticin content for the samples ranged from 0.0115 – 0.0147% m/m casticin content with an average of 0.0134%. This is well below the pharmacopoeia requirement of not less than (NLT) 0.08% casticin content as described in the British Pharmacopoeia (BP). The results obtained from the HPLC analysis were used to construct the FTIR calibration model. The calibration model consisted of 18 spectra with 530 selected data points. The model was specific for casticin as spectral regions in the calibration model can be correlated to a known IR spectral response associated with the carbonyl group of casticin. The calibration equation in the xii form of % m/m casticin content had a coefficient of determination (R2) value of 0.9855 and a root mean square error of cross-validation (RMSECV) of 0.000119. The accuracy of the model had recoveries of between 98 - 102% for the actual vs true prediction. The percentage relative standard deviation (%RSD) between nine repeated measurements was 3.46%, this does not meet the International Conference of Harmonisation (ICH) requirement for precision of not more than (NMT) 2% RSD. The range of the calibration model was between 0.01147 and 0.01469 % m/m casticin content as established by the calibration model. The robustness of the method was assessed by challenging the model with samples that fall outside of the concentration of range of the model. This was established by quantifying previously scanned samples of VAC that is not part of the calibration set. The model was able to verify if the tested samples prediction was outside of the validated calibration range. The method was subsequently also challenged with a sample of a different identity to VAC. The model indicated that the sample tested does not fall in the range of the method and was clearly recognised as an outlier. The method was rapid and does not require any expensive solvents or timeconsuming sample preparation. However, the method does not meet the ICH requirements for method validation, the method does show potential and further method development and expansion of the calibration model can ensure that the method be validated.
- Full Text:
- Date Issued: 2018
Formulation, development and assessment of tenofovir disoproxil fumarate-loaded pellets
- Authors: Dube, Tawanda
- Date: 2015
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/54690 , vital:26600
- Description: Tenofovir disoproxil fumarate (TDF) is a novel nucleotide analog reverse transcriptase inhibitor that is recommended by the WHO for use in first line treatment of HIV infections. Due to the high dose of TDF for anti-retroviral treatment the formulation of a pellet dosage form may improve patient adherence by incorporation of a large dose in a relatively small dosage form. TDF is currently only available in tablet form. A simple, sensitive, selective, rapid, accurate, precise, stability indicating reversed-phase HPLC method was developed and validated in accordance with ICH guidelines and was successfully used for the analysis of TDF raw material and pharmaceutical dosage forms. Preformulation studies included an investigation of TDF-excipient and excipient-excipient interactions with all materials that could potentially be used to produce extruded and spheronized pellets. Nuclear Magnetic Resonance spectroscopy (NMR), Infrared Spectroscopy (IR), Differential Scanning Colorimetry (DSC) and Thermogravimetric analysis were used for identification and purity testing of TDF and all excipients. DSC data revealed that no potential interactions between TDF and the excipients occurred suggesting that incompatibility reactions were unlikely during manufacture and storage. These findings were confirmed by IR analysis that revealed that no physical interaction was likely between any of the excipients used and TDF. DSC data also reveal the existence of the α and β-polymorphs of TDF as evidenced by two enthalpy changes observed on the resultant thermograms. The existence of two polymorphs is unlikely to result in incompatibility and was confirmed by IR analysis. The IR spectra reveal that all characteristic peaks for TDF were present in 1:1 binary mixtures. Therefore TDF is compatible with all excipients tested and thermal analysis confirmed the stability of TDF under manufacturing conditions. The temperature of degradation temperature established through DSC analysis confirmed that degradation during manufacture is unlikely as the temperature of manufacture is lower than that at which degradation occurs. Extrusion and spheronization were the processes used to manufacture TDF pellets as it is a simple and economic approach for production. The effects of extruder and spheronizer speed, amount of spheronization aid and diluents on the pellet size, shape, flow properties and TDF release characteristics were examined. In order to decrease the complexity of analysis and reduce the cost of development a Taguchi orthogonal array design of experiments was successfully applied to evaluate the impact of formulation variables on product characteristics and predict an optimized formulation with a minimum number of experiments. The use of Response Surface Methodology for the development and optimization of pharmaceutical systems, including the optimization of formulation composition, manufacturing processes and/or analytical methods is well established. However the application of RSM requires that accurate, precise and reproducible experimental conditions are used for the generation of reliable data and RSM use is limited due to sensitivity to experimental variability. The benefits of using RSM for formulation optimization include the fact that more than one variable can be investigated at a time and large amounts of information can be generated at the same time ensuring a more efficient process with respect to time and cost. An added advantage of this approach is that mathematical relationships can be generated for the models that are produced and provide formulation scientists with an indication of whether the effect(s) between factors are synergistic or antagonistic. There are several statistical design approaches that use RSM and a Taguchi orthogonal array design was selected for use in this optimization process as fewer experiments are required to generate data for the same number of factors to be investigated when compared to other statistical designs such as Central Composite (CCD) and Box-Behnken designs. The use of RSM clearly demonstrates the impact of different input variables on the % TDF released at 45 min and % TDF loaded into the particles. The amount of sorbitol and Kollidon® CL-M were the only significant variables that affected the % TDF released at 45 min and both excipients had an overall synergistic effect on the in vitro release of TDF. The prediction and manufacture of an optimized formulation led to the production of pellets that met predetermined specifications which was successfully achieved using RSM. The development of a TDF containing pellet dosage form has been achieved and the formulation, manufacture and characterization of the dosage form reveal that the product has the potential to be further developed.
- Full Text:
- Date Issued: 2015
- Authors: Dube, Tawanda
- Date: 2015
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/54690 , vital:26600
- Description: Tenofovir disoproxil fumarate (TDF) is a novel nucleotide analog reverse transcriptase inhibitor that is recommended by the WHO for use in first line treatment of HIV infections. Due to the high dose of TDF for anti-retroviral treatment the formulation of a pellet dosage form may improve patient adherence by incorporation of a large dose in a relatively small dosage form. TDF is currently only available in tablet form. A simple, sensitive, selective, rapid, accurate, precise, stability indicating reversed-phase HPLC method was developed and validated in accordance with ICH guidelines and was successfully used for the analysis of TDF raw material and pharmaceutical dosage forms. Preformulation studies included an investigation of TDF-excipient and excipient-excipient interactions with all materials that could potentially be used to produce extruded and spheronized pellets. Nuclear Magnetic Resonance spectroscopy (NMR), Infrared Spectroscopy (IR), Differential Scanning Colorimetry (DSC) and Thermogravimetric analysis were used for identification and purity testing of TDF and all excipients. DSC data revealed that no potential interactions between TDF and the excipients occurred suggesting that incompatibility reactions were unlikely during manufacture and storage. These findings were confirmed by IR analysis that revealed that no physical interaction was likely between any of the excipients used and TDF. DSC data also reveal the existence of the α and β-polymorphs of TDF as evidenced by two enthalpy changes observed on the resultant thermograms. The existence of two polymorphs is unlikely to result in incompatibility and was confirmed by IR analysis. The IR spectra reveal that all characteristic peaks for TDF were present in 1:1 binary mixtures. Therefore TDF is compatible with all excipients tested and thermal analysis confirmed the stability of TDF under manufacturing conditions. The temperature of degradation temperature established through DSC analysis confirmed that degradation during manufacture is unlikely as the temperature of manufacture is lower than that at which degradation occurs. Extrusion and spheronization were the processes used to manufacture TDF pellets as it is a simple and economic approach for production. The effects of extruder and spheronizer speed, amount of spheronization aid and diluents on the pellet size, shape, flow properties and TDF release characteristics were examined. In order to decrease the complexity of analysis and reduce the cost of development a Taguchi orthogonal array design of experiments was successfully applied to evaluate the impact of formulation variables on product characteristics and predict an optimized formulation with a minimum number of experiments. The use of Response Surface Methodology for the development and optimization of pharmaceutical systems, including the optimization of formulation composition, manufacturing processes and/or analytical methods is well established. However the application of RSM requires that accurate, precise and reproducible experimental conditions are used for the generation of reliable data and RSM use is limited due to sensitivity to experimental variability. The benefits of using RSM for formulation optimization include the fact that more than one variable can be investigated at a time and large amounts of information can be generated at the same time ensuring a more efficient process with respect to time and cost. An added advantage of this approach is that mathematical relationships can be generated for the models that are produced and provide formulation scientists with an indication of whether the effect(s) between factors are synergistic or antagonistic. There are several statistical design approaches that use RSM and a Taguchi orthogonal array design was selected for use in this optimization process as fewer experiments are required to generate data for the same number of factors to be investigated when compared to other statistical designs such as Central Composite (CCD) and Box-Behnken designs. The use of RSM clearly demonstrates the impact of different input variables on the % TDF released at 45 min and % TDF loaded into the particles. The amount of sorbitol and Kollidon® CL-M were the only significant variables that affected the % TDF released at 45 min and both excipients had an overall synergistic effect on the in vitro release of TDF. The prediction and manufacture of an optimized formulation led to the production of pellets that met predetermined specifications which was successfully achieved using RSM. The development of a TDF containing pellet dosage form has been achieved and the formulation, manufacture and characterization of the dosage form reveal that the product has the potential to be further developed.
- Full Text:
- Date Issued: 2015
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
Treatment of Parkinson's disease in South Africa and investigation of risk factors causing dyskinesias
- Authors: Gaida, Razia
- Date: 2012
- Subjects: Movement disorders , Parkinson's disease , Drugs
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10159 , http://hdl.handle.net/10948/d1012466 , Movement disorders , Parkinson's disease , Drugs
- Description: Background: Levodopa is still thought of as the 'gold standard' symptomatic treatment for Parkinson’s disease. However, after four to five years of treatment, levodopa efficacy tends to decline even if there was a good initial therapeutic response. The ideal treatment of Parkinson’s disease is a much debated issue with a range of guidelines available. Objectives: This study was undertaken to analyse medication use and prescribing patterns as well as to determine the risk factors involved in causing dyskinesias in Parkinson’s sufferers. Methods: The study consisted of two parts, namely a drug utilisation review (DUR) and a questionnaire survey. There were 25 523 antiparkinsonian records consisting of 5 168 patients for the year 2010. The questionnaires were verbally administered to patients diagnosed with Parkinson’s disease. A total of 43 patients were interviewed. Results: The average age of the population was 70.74±10.37 years, with the oldest patient being 100 years. Females constituted 59.17percent (5 168: n = 3 058) of the total number of patients. The most common antiparkinsonian products dispensed were combination drugs containing levodopa with a decarboxylase inhibitor and some with a COMT-inhibitor as well (46.5percent; n = 11 875). Males represented 53.49percent (43: n = 23) of the patients included in the questionnaire survey. A review of the medical records showed that patients with dyskinesias were diagnosed with Parkinson’s disease at a younger age and had experienced longer disease duration. Conclusion: Parkinson’s disease is an under-recognised condition in South Africa. Treatment needs to be individualised and based on evidence-based guidelines. Further studies in South Africa, as well as SSA (sub-Saharan Africa), need to be conducted on both the prevalence as well as the treatment of Parkinson’s disease.
- Full Text:
- Date Issued: 2012
- Authors: Gaida, Razia
- Date: 2012
- Subjects: Movement disorders , Parkinson's disease , Drugs
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10159 , http://hdl.handle.net/10948/d1012466 , Movement disorders , Parkinson's disease , Drugs
- Description: Background: Levodopa is still thought of as the 'gold standard' symptomatic treatment for Parkinson’s disease. However, after four to five years of treatment, levodopa efficacy tends to decline even if there was a good initial therapeutic response. The ideal treatment of Parkinson’s disease is a much debated issue with a range of guidelines available. Objectives: This study was undertaken to analyse medication use and prescribing patterns as well as to determine the risk factors involved in causing dyskinesias in Parkinson’s sufferers. Methods: The study consisted of two parts, namely a drug utilisation review (DUR) and a questionnaire survey. There were 25 523 antiparkinsonian records consisting of 5 168 patients for the year 2010. The questionnaires were verbally administered to patients diagnosed with Parkinson’s disease. A total of 43 patients were interviewed. Results: The average age of the population was 70.74±10.37 years, with the oldest patient being 100 years. Females constituted 59.17percent (5 168: n = 3 058) of the total number of patients. The most common antiparkinsonian products dispensed were combination drugs containing levodopa with a decarboxylase inhibitor and some with a COMT-inhibitor as well (46.5percent; n = 11 875). Males represented 53.49percent (43: n = 23) of the patients included in the questionnaire survey. A review of the medical records showed that patients with dyskinesias were diagnosed with Parkinson’s disease at a younger age and had experienced longer disease duration. Conclusion: Parkinson’s disease is an under-recognised condition in South Africa. Treatment needs to be individualised and based on evidence-based guidelines. Further studies in South Africa, as well as SSA (sub-Saharan Africa), need to be conducted on both the prevalence as well as the treatment of Parkinson’s disease.
- Full Text:
- Date Issued: 2012
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