Current Issue : April-June Volume : 2023 Issue Number : 2 Articles : 5 Articles
In April 1994, South Africa underwent the most significant change in its recent history with the disbandment of the policy of apartheid and the attendant race-based politics, which affected most aspects of the country and, of relevance to this review, the education, health delivery, and career choices that race groups could pursue. In the past 28 years, the South African government has tried to implement policies in order to advance political and socioeconomic shifts toward a more equitable society. The healthcare sector was an early target for transformation that was aimed at increasing access to services and the expansion of primary healthcare and hospital facilities to previously underserved areas. This paper seeks to discuss these changes in broad terms, but with specific reference to general health care and pharmacy practice in particular. It will look at the changes in the legislative framework and pharmacy education and factors impacting the pharmacy practices in South Africa over the past 28 years. A discussion of the critical issues that have affected the profession in the last three decades will also be delineated, and future prospects for the profession as a whole, in terms of pharmacy practice and perspectives, will be discussed. We review the current aspects of the pharmacy profession in South Africa today and how the education of those future professionals is a major contribution to the pharmaceutical climate....
Background: Drug-related problems (DRPs) are a global issue that impacts the efficacy and safety of the therapy, and pediatric patients are considered to be more vulnerable to DRPs, thus requiring more attention. Community pharmacists (CPs) are in a position that allow them to identify and alleviate these DRPs. Objectives: This study evaluated the ability of CPs in identifying and resolving DRPs in a pediatric prescription. Methods: A cross-sectional study was carried out in 235 community pharmacies to evaluate the ability of CPs working in the Khartoum locality to identify DRPs in a pediatric prescription and how they intervene to resolve these problems. Fifth-final year B. Pharm. Students were selected and trained to act as simulated patients (SPs) for this study. The visits were performed by using a simulated prescription that contains three different types of DRPs. The information obtained from the visits was documented immediately by the SPs after leaving the pharmacy in a data collection form. Results: All planned SPs visits were completed. Of the 235 community pharmacies, only 50 (21.3%) CPs were able to identify at least one of the DRPs. The most common type of DRP identified was the wrong duration of the treatment 19%, followed by the wrong dose 4%. The interventions made by CPs to mitigate the identified DRPs included recalculation and correction of the dose according to weight, which was made by 10 CPs, and correction of the duration, which was done by 45 CPs. None of the CPs who identified the presented DRPs communicated with the physician or referred the SP to the prescriber. The average dispensing time of the CPs was 68.18 ± 36.1 s. Conclusions: The majority of the CPs in the Khartoum locality were unable to identify DRPs in a pediatric prescription. Correction of the dose and duration of treatment were from the attempts of CPs to resolve DRPs. However, no collaboration was observed between CPs and physicians. In general, the practice of CPs in Khartoum locality in this area requires substantial improvement....
Medicare Annual Wellness Visits (AWVs) are annual appointments with the primary care team to prepare personalized prevention plans and focus on gaps in care. Although beneficial, AWVs are often difficult for providers to schedule and complete due to the increased time commitments compared to other visits. The purpose of this study was to assess the clinical, economic and patient-level value of newly implemented pharmacist-led AWVs within a rural Federally Qualified Health Center (FQHC). This retrospective, cohort study included patients who completed an AWV between 1 October 2021, and 14 February 2022. The primary objective was to compare the per clinician rate of completed AWVs between pharmacists and providers. The secondary objectives were to compare revenue generated, interventions made, and patient satisfaction between pharmacist- and provider-led AWVs. During the study period, nine providers completed 139 AWVs (15.4/provider) and two pharmacists completed 116 AWVs (58/pharmacist). Proportions of interventions ordered among those due in eligible patients were similar between pharmacists and providers (47.6% vs. 44.5%; p = 0.356). Patient satisfaction was overall positive with no difference between groups. Pharmacist-led AWVs increased completion of AWVs by 83% over a 20-week period, including significantly more initial, compared to subsequent, AWVs than providers. Sustainability of pharmacist-led AWVs at this FQHC is supported by study outcomes....
Hypertension is a serious health issue that affects people all over the world and remains a significant public health concern as it is linked to morbidity, mortality and economic effects on society. Premature birth, intrauterine foetal death, growth retardation and abruption placentae are all elevated hazards for pregnant women with high blood pressure. Hence, aim of this study is to evaluate prescribing pattern of antihypertensive drug in pregnancy in a tertiary care hospital. A prospective observational study was carried out in NMCH and RC for a period of 3 months from May to July. All the patients who were presented to the obstetrics and gynaecology out-patient department of the hospital were reviewed daily to identify the patients diagnosed with Pregnancy induced hypertension. A suitably designed data collection form was utilised to gather information on the patients, including their age, gestational age, gravida, parity, blood pressure status, history of previous deliveries, comorbidities and treatments received. The results indicated that, majority of participants were diagnosed with Pregnancy induced hypertension (91.66 %), followed by participants diagnosed with Preeclampsia (16.66%) and subjects corresponding to Eclampsia diagnosis (8.33%). most of the subjects (88.32 %) received monotherapy. It was found that Labetalol (68.33 %), was most common antihypertensive drug prescribed, followed by Nifidipine given to 11.66 % patients, Methyldopa prescribed to 8.33 % patients. Asthma was the major comorbidity associated with hypertension during pregnancy and was found (15%), followed by Gestational diabetes (3.33%) and Hypothyroidism (3.33%)....
Background: In recent years, pharmacists in Australia have been able to expand their scope to include the provision of a range of services. Although evidence has demonstrated the benefits of pharmacist-managed TDM services, recent studies have shown that these services are not prominent within Australia and that the current TDM workflow may not be optimal. Methods: An interventional pilot study was conducted of a pharmacist-managed TDM program for vancomycin at a tertiary hospital in Australia. Results: In total, 15 pharmacists participated in the program. They performed 50.5% of the medication-related pathology over the intervention period. Pharmacist involvement in the TDM process was more likely to lead to appropriate TDM sample collection (OR 87.1; 95% CI = 11.5, 661.1) and to an appropriate dose adjustment (OR 19.1; 95% CI = 1.7, 213.5). Pharmacists demonstrated increased confidence after the education and credentialling package was provided. Conclusions: This study demonstrated that a credentialling package for pharmacists can improve knowledge, skills, and confidence around the provision of pharmacist-managed TDM services for vancomycin. This may lead to the evolution of different roles and workflows enabling pharmacists to contribute more efficiently to improving medication safety and use....
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