Tracking adverse drug reactions and medication errors in the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa

Otwombe, Kennedy; Munsamy, Maggie; Dheda, Mukesh; Ramdas, Nishana; Herbst, Corlee; Tonder, Tanya Van; Tonder, Tanya Van; Serenata, Celicia; Lalla-Edward, Samanta Tresha

doi:10.4102/sajhivmed.v23i1.1366

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…Individual patient-based communication like medication and appointment reminders were done via telephonic follow up and short messaging systems (SMS) for Central Chronic Medicines Dispensing and Distribution (CCMDD) patients ( 24 ). However, when interventions included having to employ computers and technology, HCWs expressed feeling overwhelmed.…”

Section: Resultsmentioning

confidence: 99%

Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives

Lalla-Edward

Mosam²,

Hove³

et al. 2022

Front. Public Health

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BackgroundBetween May 2020 and February 2022, South Africa's health system bore strain as it battled mitigating the coronavirus pandemic. The country's pandemic response was scrutinized. This period also brought into focus pre-existing shortcomings in the healthcare system and its governing bodies. Contextually, there is a paucity in literature on the experiences of healthcare providers and users. This study aimed to contribute information on COVID-19, with the intention of providing guidance on preparing for future infectious disease outbreaks.MethodsCross sectional exploratory qualitative methodology was employed using semi-structured interviews and focus group discussions with community members (CM) and healthcare workers (HCW) from two South African study sites: (a) rural Bushbuckridge (run by Agincourt Health and Socio-Demographic Surveillance Site) and (b), Regions D and F in Johannesburg Metropole.ResultsAfter interviewing 42 CMs and 43 HCWs, it emerged that mandated process changes while minimizing COVID-19 exposure, necessitated healthcare personnel focusing on critical care treatment at the expense of less acute ones. COVID-19 isolation protocols, extensive absenteeism and HCWs with advanced skills being perceived as more adept to treat COVID-19 patients contributed to HCWs experiencing higher workloads. Fears regarding contracting and transmitting COVID-19, suffering financial losses, and not being able to provide adequate advice to patients were recurrent themes. Dissemination of relevant information among healthcare facility personnel and communities suffered due to breakdowns in communication.ConclusionConcessions and novel strategies to avail medication to patients had to be created. Since providence was lacking, government needs to formulate health intervention strategies that embrace health literacy, alternate methods of chronic medication dispensation, improved communication across health care platforms and the use of telehealth, to circumvent the threats of possible further infectious disease outbreaks.

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Section: Resultsmentioning

confidence: 99%

Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives

Lalla-Edward

Mosam²,

Hove³

et al. 2022

Front. Public Health

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Qualitative study exploring reintegration of clinical trial participants with HIV to public health services in Johannesburg, South Africa

Nxumalo,

Harris,

Napoles

et al. 2024

BMJ Open

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ObjectivePeople living with HIV (PLHIV) are often recruited from primary healthcare clinics (PHC) into clinical trials. On trial completion, they are transferred back to the facility for continued care and support in managing their condition, potentially leading to better health outcomes. Because transferring PLHIV back to PHCs post-clinical trials may result in decreased access to specialised care or resources that were available during the trial, this study explored insights into challenges faced during reintegration from clinical trial settings into PHCs and antiretroviral therapy (ART) adherence post-clinical trials.DesignThis cross-sectional study was conducted using a qualitative research approach. Participants were recruited using purposive sampling.SettingThe study was conducted at the Ezintsha Research Centre in Johannesburg, South Africa, between November 2022 and February 2023.ParticipantsThe study population consisted of PLHIV who had participated in two clinical trials (DORA and ADVANCE) at the Ezintsha Research Centre in Johannesburg, South Africa.MethodsUsing a semistructured guide, 12 in-depth interviews were conducted with PLHIV until data saturation was reached. Data were then transcribed verbatim and analysed thematically with MAXQDA software.ResultsThe majority (n=8, 67%) of participants were female, and the average age of all participants was 40 (SD 7.2) years. Two main themes emerged: reintegration from clinical trials to public healthcare and barriers to ART adherence. These themes were further separated into seven subthemes, namely, negative attitude of healthcare workers, poor healthcare service delivery, poor communication to patients, waiting time at healthcare facilities, lack of privacy and confidentiality, mistakes in ART dispensing and bad reception at facilities post-clinical trials.ConclusionClinical trial sites should cultivate better stakeholder engagement with PHCs to facilitate a smoother transition of research participants, especially PLHIV, back into public healthcare for continued care.

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Reducing medication errors in HIV-positive patients: Influence of a clinical pharmacist

Bronkhorst,

Joseph-Busby,

Bezuidenhout

2024

Southern African Journal of HIV Medicine

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Background: The roll-out of antiretroviral medicines has improved life expectancy in people living with HIV (PLHIV). This has resulted in more patients being hospitalised for non-communicable diseases, increasing risk for medication errors (MEs). Pharmacists, through medication reconciliation, may identify and reduce MEs in this population.Objectives: To describe the importance of a pharmacist’s involvement in identifying and quantifying types of MEs.Method: A quantitative, prospective observational study was conducted over 14 weeks. A pharmacist reviewed HIV-positive, hospitalised patients’ files, using a data collection instrument, to determine the prevalence of MEs in PLHIV. The study pharmacist recommended appropriate actions to the prescriber to resolve MEs and documented resolution of the MEs.Results: The study population of n = 180 patient files were reviewed 453 times, identifying 466 MEs. Medication errors included incorrect medication reconciliation from history (19; 4.1%), prescription omission (17; 3.7%), duplication of therapy (10; 2.2%), missed doses (265; 57.1%), incorrect dosing (103; 22.2%), incorrect administration frequency (2; 0.4%), incorrect duration of therapy (15; 3.2%) and drug-drug interactions (18; 3.9%). More than half (58.2%) of the MEs were resolved in less than 24 h, with involvement of the pharmacist.Conclusion: This study demonstrates the magnitude of MEs experienced in hospitalised PLHIV and highlights the role clinical pharmacists play in identifying and resolving MEs to improve patient outcomes.

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Tracking adverse drug reactions and medication errors in the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa

Cited by 3 publications

References 15 publications

Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives

Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives

Qualitative study exploring reintegration of clinical trial participants with HIV to public health services in Johannesburg, South Africa

Reducing medication errors in HIV-positive patients: Influence of a clinical pharmacist

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