No abstract available. / Thesis (MBA)-University of Natal, 2002.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, Technikon Natal, 1997. / The aim of this study was to assess pharmacists' perception of complementary medicine in the health care system of South Africa / M

South Africa has a high prevalence of infectious diseases; the major ones being the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome epidemic, and tuberculosis. South Africa’s burden of resistant bacteria is also increasing. Antibiotic resistance in hospitalised patients leads to an increase in morbidity and mortality, resulting in longer hospital stays, and an increase in hospital costs. In order to counteract the problem of antibiotic resistance in hospitals and other healthcare facilities and preserve the efficacy of currently available antibiotics, there is a need for serious antibiotic management. Antibiotic stewardship initiatives have thus been put in place to guide healthcare professionals on the correct use of antibiotics. Clinical pharmacists can intervene and contribute to antibiotic stewardship owing to comprehensive knowledge of antibiotics, including the properties, uses, safety and efficacy of individual agents. There is a paucity of research to support the role of the clinical pharmacist in antibiotic stewardship in public sector hospitals. The current pharmacist staffing system within public sector hospitals does not adequately support pharmacists, in particular clinical pharmacists, to participate actively in antibiotic stewardship. The primary aim of the study was to evaluate the role of the clinical pharmacist in antibiotic stewardship in a public hospital setting. A secondary aim was to contribute towards more rational inpatient use of antibiotics in the general medical ward. The hypothesis for the study was that clinical pharmacists can make a positive contribution to the correct use of antibiotics in a public hospital setting. The study showed that the introduction of a pharmacist-driven antibiotic stewardship in the ward, using a prospective audit and feedback strategy, had a positive effect on overall appropriateness of antibiotic prescribing (Chi2=7.89; df=3; p=0.04815, Cramer’s V=0.13). However, this finding did not show any reduction in the volume of antibiotic use. Positive patient outcomes were achieved and shown through a reduction in the length of hospital stay (p=0.00487; one-way ANOVA). Although patients were not followed up on discharge to assess re-admission rates, the results are relevant in order to inform the hospital staff about the implementation of antibiotic stewardship at the public hospital setting with the aims of reducing inappropriate antibiotic prescribing and improving patient outcomes. From the results of the study, it can be concluded that the hypothesis was achieved and that the clinical pharmacist did play an integral role in antibiotic prescribing at the public hospital setting. Thus, it can be concluded that the study, though limited in its scope, achieved its aims and objectives, and showed that the clinical pharmacist does play an integral role in the rational use of antibiotics in a public hospital setting.

There is a severe shortage of pharmacists in the Nelson Mandela Metropole with a current vacancy rate of over 50 percent on the approved posts for pharmacists (PERSAL 31 December 2007). The metropole has struggled to retain pharmacists in spite of the urban setting. The aim of this research was to measure the level of job satisfaction amongst pharmacists working in the public sector of the Nelson Mandela Metropole. The research objective was to conduct a questionnaire-based survey of pharmacists working in public sector facilities in the Nelson Mandela Metropole in order to assess their levels of job satisfaction, and report the findings with appropriate recommendations to management. For this study, the modified JDI Index survey was used focusing on the subscales; work, pay, promotion, supervision, co-workers and patient interaction. Possible retention strategies were also investigated through the use of open ended questions. The questionnaire was administered to 30 pharmacists in full time employment within the public sector in the Nelson Mandela Metropole. A total of 25 questionnaires were returned giving an 83.3 percent response rate. The pharmacists were generally satisfied with the job, their pharmacy co-workers, patient interaction and supervision but were not satisfied with salary and promotion opportunities in the public sector. Using a score from 1 to 5, with 5 indicating a level of high satisfaction, the mean scores for the six subscales were, job (3.2), income (2.1), patient interaction (3.3), promotion (2.0), co-workers (3.4) and supervision (3.7). Financial packages (23, n=25) and fringe benefits (22, n=25) were indicated as the most effective strategies in attracting and retaining pharmacists into the public service. The majority of respondents (15, n=25) agreed that the favourable working hours, flexibility of work, regular working hours with no weekend duties were the most vii positive aspects about their job. The negative aspects mentioned by the majority of the respondents (15, n=25) included poor remuneration, unrealistic notch increases and salaries that were not market-related and uncompetitive.

Thesis (MBA)--Stellenbosch University, 2014. / The South African healthcare industry has undergone numerous changes over the last two decades in both the public and private sectors. These changes have influenced the regulatory landscape of both sectors with the aim of improving accessibility to healthcare services and providers, and making healthcare more affordable for the South African public. The South African government introduced the Medical Schemes Act No. 131 of 1998, in response to issues faced in the medical scheme industry. The act allowed for a board of trustees to regulate medical schemes in their governance (McIntyre, Thiede, Nkosi, Mutyambizi, Castilo-Riquelme, Gilson, Erasmus & Goudge, 2007). The main aim was to ensure medical schemes were able to maintain solvency levels and maintain benefits offered to beneficiaries. The pharmaceutical industry saw legislative changes governing the pricing of medicines, generic substitution of medicines and open ownership of pharmacies. The researcher aimed to provide the medical scheme industry with valuable insight into the challenges experienced by pharmacists, when processing and submitting claims for medical scheme members and their beneficiaries. The intention was to enable the medical scheme industry to improve service quality and efficiency in provider relationships, and customer relationships. The research consisted of qualitative and quantitative research methods. A focus group interview consisted of the initial phase, producing qualitative data. The researcher utilised the qualitative data to construct an online questionnaire, which he then sent out through email, to a larger group of retail pharmacists in KwaZulu-Natal. The majority of retail pharmacists who participated in the research had a limited knowledge of all medical schemes and the different options available in South Africa. The majority of pharmacists in both groups were of the opinion that the redesigning and simplification of computer programmes, utilised for submitting prescriptions, would improve efficiency in service delivery. The research further found that the dissemination of information, on a variety of topics, from medical schemes to their members and service providers, should improve to increase efficiency in service delivery and foster better relationships.

The research problem addressed in this study was to determine whether successful retail pharmacists exhibited specific traits. To achieve this objective a theoretical schedule of traits was developed, using relevant literature in which traits of entrepreneurs are described. The theoretical list consisted of the possession of the following traits: The need to achieve; Confidence in their abilities; The successful management of risk; Creativity and the possession of vision; The tendency/ability to view changes as opportunities; Internal locus of control; Leadership; High level of motivation; Tenacity; Communication skills. Each trait of the schedule was analysed using the literature identified during the literature study. The theoretical list was then used to develop a questionnaire to test the degree to which retail pharmacists in the Greater Port Elizabeth/Uitenhage Metropole concur. The empirical results obtained indicate a strong concurrence with the theoretical list of traits of successful retail pharmacists that was developed in the study. This resulted in the theoretical schedule being confirmed and accepted as a list of traits possessed by successful retail pharmacists.

Medication errors are becoming problematic in both hospital and outpatient settings worldwide. Inappropriate use of medication can cause harm to the patient and maintaining high levels of quality patient care is essential to protect all patients. Clinical pharmacy practice contributes to improved patient care by optimising medication therapy; and promoting health, wellness and disease prevention. The involvement of a pharmacist at a ward level has been shown to improve patient care; reduce mortality and morbidity rates; decrease healthcare costs; minimise medication errors; and improve outcomes of drug therapy. However, clinical pharmacy is a fairly new practice in South Africa and there are limited studies available. This study aimed to evaluate the perceived benefits of a ward-based pharmacist on the provision of pharmaceutical care to patients in a hospital setting and to consequently implement a ward-based pharmacy service. The objectives of the study were: (1) to assess, via a questionnaire, the perceptions and attitudes of medical practitioners and nurses to ward-based pharmacy prior to and after implementation of a ward-based pharmacy service, (2) to implement a ward-based pharmacy service in a selected hospital ward; (3) to document and analyse the nature of the work and activities that a ward pharmacist undertakes, and (4) to document and analyse the frequency and nature of ward pharmacist interventions. The study was conducted in a surgical ward of a private hospital in the Eastern Cape. The study design was an intervention study, using a mixed-methods design, with a convergent approach. A convenience sample of 106 patients was obtained over the eight week study period. Participation was voluntary and confidentiality was maintained at all times. Four data collection tools were used during the study and a pilot study was conducted to ensure their validity and reliability. The quantitative data was analysed statistically while the qualitative questions were analysed through coding the various responses. The results of the study showed that medical practitioners and nurses of a surgical ward had a positive attitude towards ward pharmacy both prior to and after the implementation of a ward pharmacy service. There were ward pharmacist interventions made in 50% (n=106) of the patients who participated in the study. A large percentage (57%; 50; n=87) of the ward pharmacist interventions were pharmacist-initiated interventions to optimise patient care while prescribing errors (51%; 19; n=37) were the most commonly occurring medication error. The majority of the medication items involved in the interventions (34%; 34; n=101) were related to the anti-microbial medication class. Overall, there was a 73% (36; n=49) acceptance rate of the ward pharmacist interventions that were made to both the medical practitioners and nurses. There were a number of factors that had a significant relationship with a ward pharmacist intervention being required which included: (1) number of medication items (p=0.001; Chi² test; p<0.0005 Student’s t-test), (2) length of hospital stay (p<0.0005; Chi² test), (3) presence of one or more chronic disease states (p=0.003; Chi² test) and (4) presence of one or more allergies (p=0.028; Chi² test). The ward pharmacist interventions were shown to be of clinical significance and to have a positive impact on the patients concerned. It can be concluded that the ward pharmacy service was beneficial to the patients, medical practitioners and nursing staff.

The main objective of this study was to investigate factors contributing to employee turnover in the South African pharmaceutical industry and to suggest strategies to minimize it. Employee turnover is a persistent problem facing both public and private organizations in South Africa. In addition to the costs incurred when an employee resigns, losing employees results in a loss of knowledge, skills and experience. Numerous studies have been undertaken globally on this topic. However, this problem continues to adversely affect organizations in several ways. Schwab (1991) suggests that this is because there are no clear resolutions yet to this challenge. Based on literature review conducted, there is no study undertaken in South Africa attempting to address this problem. The purpose of this study was to identify factors contributing to high turnover rate of pharmacists in South Africa (the pharmaceutical industry in particular) and to recommend strategies to address this problem. A quantitative research approach was followed when addressing this problem. Literature review was conducted on employee turnover and a questionnaire was developed. The questionnaire was used as a measuring instrument. Following a non-probability, convenience sampling method, two pharmaceutical companies in Gauteng and one in the Eastern Cape were surveyed. The results were analysed by a statistician using Epi-info and stata software as tools for statistical analysis. The following factors were found to be key factors contributing to employee turnover in the pharmaceutical industry: (i) lack of career advancement opportunities, (ii) uncompetitive salary packages, (iii) perceived inequity reflecting leadership challenges, (iv) insufficient recognition for good performance, (v) stress, and (vi) insufficient retention strategies. An effective retention strategy should address all factors that may contribute to employee turnover. A retention strategy that combines competitive salary packages, opportunities for learning and career advancement, recognition, equity and support structures (to deal with stress), should be used in the pharmaceutical industry. This will assist in creating a motivating climate, which is a pre-requisite for job satisfaction and, in turn, employee retention.

Thesis (M.Pharm.) -- University of Limpopo -- 2020 / Background: Non-communicable diseases (NCDs) which are chronic diseases in nature, have been the most common cause of death and disability globally for the last three decades. The prevalence of hypertension in South Africa has been estimated to be 20% of the adult population with over six million people being affected. Patient’s knowledge and awareness of blood pressure plays an important role in achieving successful control of hypertension. Although it is important for a physician to be involved in this educational process, pharmacists also have a role to play in this regard. Given their accessibility and drug therapy expertise, pharmacists are a logical choice and a valuable asset to improve hypertension management via team-based care and also when they are in direct consultation with the patients. Methods: The study involved both qualitative and quantitative research methods. A pre-validated questionnaire was used to collect data from 341 patients attending the 4 clinics at Ga-Dikgale. A semi-structured one-on-one interviews were used as data collection for 20 pharmacists working at Mankweng hospital until saturation was reached. Results: On the knowledge about definition, 30.7% were knowledgeable and 5.8% were highly knowledgeable. On the knowledge about treatment, 48% were highly knowledgeable. With regards to lifestyle modifications 77.8% were highly knowledgeable. For complications of hypertension, 63.2% were highly knowledgeable. Amongst the participants level of education proved to play a significant role on the knowledge of hypertension. The study also revealed that pharmacists shared similar practices in the management of hypertension. The following themes emerged from the data analysis, using Tesch’s inductive, descriptive coding technique of qualitative data analysis: Perceived roles of pharmacists during the management of hypertensive patients, expectations of pharmacists during provision of medication to hypertensive patients, and challenges related to pharmacists’ practices during care of hypertensive patient}s. Conclusions: The results of the quantitative study indicated that participants at Dikgale have good knowledge about hypertension, although previous studies indicate high rates of cardio-metabolic risk factors for hypertension. Further studies need to be conducted to determine reasons for patients not practicing lifestyle modifications. The results of the qualitative study indicated that there are common practices of pharmacists in the management of hypertension. More attention should be focused on training pharmacists on how to provide comprehensive counselling to hypertensive patients. There should also be workshops for pharmacists on how to efficiently educate patients on hypertension. / VLIR

Thesis (M. A. (PHARM.) -- University of Limpopo, 2019 / Introduction Multidisciplinary team (MDT) approach has emerged as one solution to improving chronic kidney disease (CKD) care. The MDT may include a nephrologist, physicians, nurses, dietitians, pharmacists, and social workers, all working together to deliver effective care to patients with CKD. Participation of pharmacists within the renal MDT at Polokwane hospital seems to be limited. The perceived barriers to pharmacists providing renal care services to CKD patients at Polokwane hospital could inform future strategy development, to enhance their participation. The aim of this study was to explore the role of pharmacists in renal care and develop strategies to maximise their participation in the renal multidisciplinary health care team, based on their participation at Polokwane hospital, Limpopo province. Method A qualitative study using semi-structured interviews was conducted with a purposeful sample of 8 members of the renal MDT and 9 pharmacists. The audiotaped interviews were transcribed exactly as said and analysed using thematic content analysis. Results Four themes emerged from the analysis: ‘pharmacist’s current scope of practice within the renal MDT’, ‘potential future roles of pharmacists’, ‘perceived barriers to participation of pharmacists within the renal MDT’ and ‘recommendation/Strategies to incorporate pharmacists into the MDT’. Results have shown that pharmacists have an absent role within the renal MDT. Their role is limited to just dispensing and managing stock, with no role in direct patient care. Both pharmacists and MDT members showed preference to working together during renal care. Pharmacy services suggested include medication reviews, provision of patient education and counselling, patient adherence improvement, dosage workouts, patient monitoring and education on contraindicated drugs and drug interactions. Shortage of staff, pharmacists lack of clinical skills, lack of communication and attitude of pharmacists were perceived as the major barriers to participation of pharmacists within the renal xii MDT. To overcome these barriers, it was recommended that the department of health (DoH) provide more pharmacy staff and educational opportunities in the form of workshops, to equip pharmacists clinically and broaden competency and knowledge on effective communication and coordination. In addition, it was recommended that the clinical curriculum at Universities be revised, to build solid foundation on MDT care and pharmacology and that the MDT programme be standardized through standard treatment guidelines (SOP’s), policies and drawing of job descriptions. Conclusion The role of pharmacists at Polokwane hospital is confined to just stock management and dispensing. There are promising avenues for future development of their role during patient care, which can be achieved by addressing the barriers highlighted Recommendations The expansion of the role of pharmacists within the renal MDT will require improved partnership between health care professionals, resources, legislations and guidance from formal SOPs. Having a national framework for pharmacy practice from Ministry of Health, supported by educational opportunities and a pro-active professional association would be key to incorporating pharmacists within the renal MDT.