The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

Diabetes mellitus is a complex disease that requires constant patient compliance to diet, life style, glucose level monitoring and medication. Non-compliance to medication can be associated with the development of complications, avoidable hospitalization, disease progression, premature disability and death. Noncompliance is also very costly and therefore compliance to medication regimens is very important. A promising, yet under-explored approach to compliance is self-regulation. Selfregulation refers to the process of goal setting and striving. Self-regulation has specifically been associated with success in reaching one’s goals. The key selfregulation processes include goal establishment, planning, striving towards a goal and revising it. Although a large number of studies have been conducted on compliance related to diabetes, there is a lack of research findings from a selfregulation perspective. The aim of this study is to investigate the relationship between self-regulation and patient compliance to type I and type II medication. Specific aims are (a) to determine whether there is a significant difference in the mean self-regulation scores for participants high and low in compliance and (b) to determine whether there are significant differences in the mean self-regulation scores between compliant and non-compliant participants within different gender and age groups. The participants consisted of an availability sample of 50 (31 female and 19 male) type I and type II diabetes patients collecting their medication at the Clicks Pharmacy in Potchefstroom and Trans 50 retirement villages in Pretoria, Bloemfontein and Kimberley. The ages of the participants ranged between 20 and 87 years. Compliance was measured by investigating the participants’ repeat scripts as well as the Clicks Medication Therapy Management Questionnaire (MTM-Q), developed in 2009 by pharmacists at Clicks to measure patients’ self-report of compliance. Selfregulation was measured with the Shortened Self-Regulation Questionnaire (SSRQ) (Carey, Neal, & Collins, 2004). The study used the factor structure proposed by Potgieter and Botha (2009), based on a factor analysis of the SSRQ in the South- African context. Data capturing and analysis was done in consultation with the Statistical Consultation Services of the North-West University. A total number of 28 (56%) participants in this study were classified as compliant, which is lower than compliance figures reported in most international studies. Differences between compliant and non-compliant participants were primarily noted with regard to Mindful Awareness, Monitoring and Decision making. No differences were noted between any of the groups regarding Learning from mistakes, Perseverance, or Self-evaluation. Compliant participants in the total, female and older groups scored higher on Mindful Awareness than non-compliant participants. For older participants, this difference was practically significant. Compliant participants in the female and older group also obtained higher scores on Monitoring, with the difference in the female group practically significant. Surprisingly, noncompliant female participants scored higher on Decision Making than compliant female participants. Compliant and non-compliant male and younger participants, however, did not differ on any of the self-regulation factors. The study emphasizes the fact that diabetes is perceived as a significant challenge to the current goals of the patient. Subsequently, this study confirms, to a large extent, the importance of self-regulation in compliance to type I and type II diabetes medication, providing support for international studies that emphasise the importance of behavioural factors in diabetes. Mindfulness and Monitoring emerged as important factors in this study, and was explained in relation to compliance as a challenge to one’s perceptual awareness and ability to continuously generate feedback regarding one’s health status. The reason for gender and age related differences in the relationship between compliance and self-regulation, however, is not totally clear and needs to be explored in further research. An important limitation of the study is the small sample size that was used. Future research should explore the trends emerging from this study in larger, random samples. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Diabetes mellitus is a complex disease that requires constant patient compliance to diet, life style, glucose level monitoring and medication. Non-compliance to medication can be associated with the development of complications, avoidable hospitalization, disease progression, premature disability and death. Noncompliance is also very costly and therefore compliance to medication regimens is very important. A promising, yet under-explored approach to compliance is self-regulation. Selfregulation refers to the process of goal setting and striving. Self-regulation has specifically been associated with success in reaching one’s goals. The key selfregulation processes include goal establishment, planning, striving towards a goal and revising it. Although a large number of studies have been conducted on compliance related to diabetes, there is a lack of research findings from a selfregulation perspective. The aim of this study is to investigate the relationship between self-regulation and patient compliance to type I and type II medication. Specific aims are (a) to determine whether there is a significant difference in the mean self-regulation scores for participants high and low in compliance and (b) to determine whether there are significant differences in the mean self-regulation scores between compliant and non-compliant participants within different gender and age groups. The participants consisted of an availability sample of 50 (31 female and 19 male) type I and type II diabetes patients collecting their medication at the Clicks Pharmacy in Potchefstroom and Trans 50 retirement villages in Pretoria, Bloemfontein and Kimberley. The ages of the participants ranged between 20 and 87 years. Compliance was measured by investigating the participants’ repeat scripts as well as the Clicks Medication Therapy Management Questionnaire (MTM-Q), developed in 2009 by pharmacists at Clicks to measure patients’ self-report of compliance. Selfregulation was measured with the Shortened Self-Regulation Questionnaire (SSRQ) (Carey, Neal, & Collins, 2004). The study used the factor structure proposed by Potgieter and Botha (2009), based on a factor analysis of the SSRQ in the South- African context. Data capturing and analysis was done in consultation with the Statistical Consultation Services of the North-West University. A total number of 28 (56%) participants in this study were classified as compliant, which is lower than compliance figures reported in most international studies. Differences between compliant and non-compliant participants were primarily noted with regard to Mindful Awareness, Monitoring and Decision making. No differences were noted between any of the groups regarding Learning from mistakes, Perseverance, or Self-evaluation. Compliant participants in the total, female and older groups scored higher on Mindful Awareness than non-compliant participants. For older participants, this difference was practically significant. Compliant participants in the female and older group also obtained higher scores on Monitoring, with the difference in the female group practically significant. Surprisingly, noncompliant female participants scored higher on Decision Making than compliant female participants. Compliant and non-compliant male and younger participants, however, did not differ on any of the self-regulation factors. The study emphasizes the fact that diabetes is perceived as a significant challenge to the current goals of the patient. Subsequently, this study confirms, to a large extent, the importance of self-regulation in compliance to type I and type II diabetes medication, providing support for international studies that emphasise the importance of behavioural factors in diabetes. Mindfulness and Monitoring emerged as important factors in this study, and was explained in relation to compliance as a challenge to one’s perceptual awareness and ability to continuously generate feedback regarding one’s health status. The reason for gender and age related differences in the relationship between compliance and self-regulation, however, is not totally clear and needs to be explored in further research. An important limitation of the study is the small sample size that was used. Future research should explore the trends emerging from this study in larger, random samples. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

The mining industry in South Africa plays a significant role in the economy of the country. South Africa is rated as one of the world’s largest producers of key reserves - gold, manganese ore and platinum– and the high level of industrial and production skills in the mines also contributes to the country’s success. Although the gold mining industry’s contribution is of the utmost importance, it is also under pressure to remain competitive and cost–efficient. Old shafts, worsening health of employees, ore bodies that are not always in their prime phase, the radical increase in the annual electricity tariffs and the possibility of decreased gold prices contribute to the decline in the gold mining industry’s success. The objective of this study was to investigate the relationship between role–specific stress and physical and psychological health, and to determine whether social support has a moderating effect in this relationship for employees in a mining training academy. A cross–sectional survey design was used and a convenience sample (n=437) was taken from a South African gold mining company, where the only criterium for inclusion was to be employed by the organisation at the time the research took place. Descriptive statistics and inferential statistics were used to analyse the data. The measuring instruments used in this study were proven to be reliable. The results indicate that role stressors and physical and psychological health problems are positively related. It also shows that social support can decrease role–specific stress and that social support – especially from colleagues and supervisors – can help to reduce depression and improve the quality of sleep. Furthermore, logistic regression analyses were used to determine whether role stress and social support hold any predictive value regarding physical and psychological health. It was found that if participants’ experience role–specific stress and they receive support – especially from supervisors – it can predict their quality of sleep and the use of medication (physical viii health). The findings also indicate that role stress can predict the experience of depression with regards to psychological health. However, the moderating effect of social support between role stress and depression was not supported in this research. To conclude, recommendations for the organisation and future research are made. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2012.

The mining industry in South Africa plays a significant role in the economy of the country. South Africa is rated as one of the world’s largest producers of key reserves - gold, manganese ore and platinum– and the high level of industrial and production skills in the mines also contributes to the country’s success. Although the gold mining industry’s contribution is of the utmost importance, it is also under pressure to remain competitive and cost–efficient. Old shafts, worsening health of employees, ore bodies that are not always in their prime phase, the radical increase in the annual electricity tariffs and the possibility of decreased gold prices contribute to the decline in the gold mining industry’s success. The objective of this study was to investigate the relationship between role–specific stress and physical and psychological health, and to determine whether social support has a moderating effect in this relationship for employees in a mining training academy. A cross–sectional survey design was used and a convenience sample (n=437) was taken from a South African gold mining company, where the only criterium for inclusion was to be employed by the organisation at the time the research took place. Descriptive statistics and inferential statistics were used to analyse the data. The measuring instruments used in this study were proven to be reliable. The results indicate that role stressors and physical and psychological health problems are positively related. It also shows that social support can decrease role–specific stress and that social support – especially from colleagues and supervisors – can help to reduce depression and improve the quality of sleep. Furthermore, logistic regression analyses were used to determine whether role stress and social support hold any predictive value regarding physical and psychological health. It was found that if participants’ experience role–specific stress and they receive support – especially from supervisors – it can predict their quality of sleep and the use of medication (physical viii health). The findings also indicate that role stress can predict the experience of depression with regards to psychological health. However, the moderating effect of social support between role stress and depression was not supported in this research. To conclude, recommendations for the organisation and future research are made. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2012.

Pharmaceutical care can be defined as “the care that a given patient requires and receives which assures safe and rational drug usage” (Mikael et al., 1975:567). The supply of medication is an important link in the health care chain, and the supply of chronic medication specifically was reviewed in this study. The World Health Organization (WHO, 2008d) states that chronic disease and related deaths are increasing in low- and middle-income countries, causing 39% and 72% of all deaths in low- and middle-income countries respectively. The main objective of this study was to investigate the difference between chronic medication prescribing patterns and subsequent claiming patterns for community (retail) and mail order (courier) pharmacies in the South African private health care sector. Computerized claims data for the period 1 January 2009 to 31 December 2010 were extracted from the database of a South African pharmaceutical benefit management company. The chronic database consisted of 6 191 147 prescriptions (N = 17 706 524), 14 045 546 items (N = 42 176 768) at a total cost of R2 126 516 154.00 (N = R4 969 436 580.88). A quantitative, retrospective, cross-sectional drug utilisation review was conducted, and data were analysed using the Statistical Analysis System® programme. Various providers of chronic medication were analysed, namely dispensing doctors, dispensing specialists, courier pharmacies and retail pharmacies. Chronic medication represented 34.97% of all medication prescribed. Retail pharmacies dispensed 79% of this chronic medication (n = 2 441 613 items) and courier pharmacies 19% (n = 610 964 items). Courier pharmacies dispensed 1 147 687 prescriptions containing chronic medication and retail pharmacies dispensed 4 900 282. The average cost per prescription for chronic medication at retail pharmacies was R325.43 ± R425.74 (2009) and R335.10 ± R449.84 (2010), and that of courier pharmacies was R398.56 ± R937.61 in 2009 and R436.57 ± R1199.46 in 2010. The top-five chronic medication groups dispensed by both these pharmacy types were selected according to the number of unique patients utilising these medications for at least four consecutive months. The most utilised chronic medication groups were ACE inhibitors (n = 1 611 432), statins (n = 1 449 732), diuretics (n = 962 670), thyroid medication (n = 885 891) and oral antidiabetics (n = 696 631). The average medication possession ratio for retail pharmacies indicated that, on average, statins, diuretics, thyroid medication and oral antidiabetics were undersupplied by retail pharmacies. Courier pharmacies tended to oversupply more often than retail pharmacies, with the cost of oversupplied medication ranging from 9% to 11% of total courier pharmacy medication costs. The average chronic prescription, item and levy cost did not vary significantly between courier and retail pharmacies. This indicates that the relative cost of acquiring chronic medication is similar at retail and courier pharmacy. The medication possession ratios of the top-five chronic medication groups, however, did differ significantly. In order to choose the most appropriate provider, the medical scheme provider needs to consider the over- and undersupply of medication. Oversupply may lead to unnecessary costs whilst undersupply may lead to future noncompliance and associated health problems. The costs associated with undersupply of medication in the South African health care sector need further investigation. / PhD (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Pharmaceutical care can be defined as “the care that a given patient requires and receives which assures safe and rational drug usage” (Mikael et al., 1975:567). The supply of medication is an important link in the health care chain, and the supply of chronic medication specifically was reviewed in this study. The World Health Organization (WHO, 2008d) states that chronic disease and related deaths are increasing in low- and middle-income countries, causing 39% and 72% of all deaths in low- and middle-income countries respectively. The main objective of this study was to investigate the difference between chronic medication prescribing patterns and subsequent claiming patterns for community (retail) and mail order (courier) pharmacies in the South African private health care sector. Computerized claims data for the period 1 January 2009 to 31 December 2010 were extracted from the database of a South African pharmaceutical benefit management company. The chronic database consisted of 6 191 147 prescriptions (N = 17 706 524), 14 045 546 items (N = 42 176 768) at a total cost of R2 126 516 154.00 (N = R4 969 436 580.88). A quantitative, retrospective, cross-sectional drug utilisation review was conducted, and data were analysed using the Statistical Analysis System® programme. Various providers of chronic medication were analysed, namely dispensing doctors, dispensing specialists, courier pharmacies and retail pharmacies. Chronic medication represented 34.97% of all medication prescribed. Retail pharmacies dispensed 79% of this chronic medication (n = 2 441 613 items) and courier pharmacies 19% (n = 610 964 items). Courier pharmacies dispensed 1 147 687 prescriptions containing chronic medication and retail pharmacies dispensed 4 900 282. The average cost per prescription for chronic medication at retail pharmacies was R325.43 ± R425.74 (2009) and R335.10 ± R449.84 (2010), and that of courier pharmacies was R398.56 ± R937.61 in 2009 and R436.57 ± R1199.46 in 2010. The top-five chronic medication groups dispensed by both these pharmacy types were selected according to the number of unique patients utilising these medications for at least four consecutive months. The most utilised chronic medication groups were ACE inhibitors (n = 1 611 432), statins (n = 1 449 732), diuretics (n = 962 670), thyroid medication (n = 885 891) and oral antidiabetics (n = 696 631). The average medication possession ratio for retail pharmacies indicated that, on average, statins, diuretics, thyroid medication and oral antidiabetics were undersupplied by retail pharmacies. Courier pharmacies tended to oversupply more often than retail pharmacies, with the cost of oversupplied medication ranging from 9% to 11% of total courier pharmacy medication costs. The average chronic prescription, item and levy cost did not vary significantly between courier and retail pharmacies. This indicates that the relative cost of acquiring chronic medication is similar at retail and courier pharmacy. The medication possession ratios of the top-five chronic medication groups, however, did differ significantly. In order to choose the most appropriate provider, the medical scheme provider needs to consider the over- and undersupply of medication. Oversupply may lead to unnecessary costs whilst undersupply may lead to future noncompliance and associated health problems. The costs associated with undersupply of medication in the South African health care sector need further investigation. / PhD (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

One of the aims included in the United Nations Millennium Development Goals is to decrease the number of the world’s population without access to sanitation and water that is safe, by half by the year 2015. The use of water that is not safe for consumption leads to water–related diseases. For the purpose of this study gastro–intestinal disease was redefined as diseases of the gastro–intestinal tract caused by pathogens that spread via contaminated drinking water, poor sanitation and inadequate hygiene. Information obtained regarding the use of gastro–intestinal disease medication, may provide information about the prevalence of gastro–intestinal disease in South Africa. The general objective of this study was to determine the prescribing patterns of gastro–intestinal medication in different geographical areas in the private health care sector of South Africa. A retrospective drug utilisation review was conducted on data obtained from a medicine claims database of a pharmacy benefit management company for 2007 and 2008. A pharmacoepidemiological approach was followed in order to determine the prevalence of gastro–intestinal disease as well as the use of gastro–intestinal medication in South Africa as well as the different provinces of South Africa. The impact of water quality and sanitation on the prevalence of gastro–intestinal disease was also investigated. Gastro–intestinal medication (used in the treatment of gastro–intestinal disease) included the following pharmacological groups according to the MIMS®–classification: antivertigo and anti–emetic agents (group 1.8), antispasmodics (group 12.3), antidiarrhoeals (group 12.7), minerals and electrolytes (group 20.4, selected according to specified NAPPI–codes) and antimicrobials (group 18). Antimicrobials had to be prescribed in combination with one of the specified gastro–intestinal medication groups in order to be classified as a gastro–intestinal medication. In 2007 and 2008 respectively, 428864 and 340921 gastro–intestinal medication items were prescribed. The most frequently prescribed gastro–intestinal medication pharmacological groups in 2007 and 2008 were beta–lactam antimicrobials (with proportion percentages of 22.77% and 20.85% in 2007 and 2008 respectively), antivertigo and anti–emetic agents, antispasmodics, antidiarrhoeals and quinolone antimicrobials. Minerals and electrolytes represented only a small proportion (2.99% and 2.56% in 2007 and 2008 respectively) of the prescribed gastro–intestinal medication in South Africa. In the Free State and Western Cape antivertigo and anti–emetic agents were the most frequently prescribed gastro–intestinal medication items, while in other provinces beta–lactam antimicrobials ranked the highest. In all provinces except the Western Cape and the Northern Cape, amoxicillin/clavulanic acid was the most frequently prescribed gastro–intestinal medication active ingredient. In the Western Cape loperamide was the most frequently prescribed active ingredient, while ciprofloxacin ranked highest as active ingredient in the Northern Cape in 2008. Based on the prescribing patterns of gastro–intestinal disease medications the treatment of gastro–intestinal disease in this section of the private health care sector of South Africa, does not fully comply with the Standard Treatment Guidelines with regard to the use of antimicrobials and electrolyte replacement therapy. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

The prevalence of epilepsy in society is general knowledge; however the impact on social activity as well as other daily factors are not always fully recognised. Epilepsy frequently poses a problem with regard to work–related activities (Heaney, 1999:44). Moran et al. (2004:425) indicated that the major impacts of epilepsy on life were work and school difficulties, driving prohibition, psychological and social life of which restriction of work or schooling has the greatest impact on epileptic’s life. In all cases the type, severity, and frequency of the seizures as well as the age would be relevant. Davis et al. (2008:451) established that 39% of all epileptics were not adherent to their therapy and in patients over 65 this was even higher at 43 %. Non–adherence with antiepileptic medicine appears to be related to increased health care utilisation and costs and may also lead to an increased probable accidents or injuries The general objective was to investigate anti–epileptic medicine prescribing patterns and treatment cost in a section of the private health care sector by using a medicine claims database. A retrospective drug utilisation study was done on the data claims from a pharmacy benefit management company for the study period 1 January 2005 to 31 December 2008. Firstly epilepsy was investigated in order to understand the disease and to determine the prevalence and treatment thereof. It was found that epilepsy is still one of the most common neurological conditions and according to the findings, 2 out of every hundred patients were using anti–epileptic medicine in this section of the private health care sector. To make this condition socially more acceptable and understandable, public education for special target groups concerning the disorder must be conducted as well as employment training programmes for people with epilepsy themselves. The utilisation patterns of anti–epileptic drugs were reviewed, analysed and interpreted. It was determined that anti–epileptic medicine items are relatively expensive with regards to other medicine items on the total database. With regard to gender, more females are using anti–epileptic medicine than males on the database. The largest age group of patients using anti–epileptic medicine, is between > 40 years and <= 64 years of age. It was also clear that prevalence increase as age increase. With regard to the different prescribers, the number of items prescribed by a general practitioner was almost double that of the other prescribers. It was further established that newer anti–epileptic medicines are more expensive than older anti–epileptic medicine according to the cost per tablet in this section of the private health care sector. Carbamazepine and valproate were the two active ingredients that were most frequently prescribed as a single item on a prescription. After a cost–minimisation analysis was done, R134 685.66 could have been saved when generic substitution was implemented. The refill–adherence rate decreased as age increased. Only 30.46% of the trade names was refilled according to acceptable refill–adherence rates. The refill–adherence rate according to active ingredient showed that medicine items containing, phenobarbitone/vit B or gabapentin had the lowest unacceptable refill–adherence rate. The limitations for this study was stipulated and recommendations for further research regarding anti–epileptic medicine were also made. / Thesis (M.Pharm (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.