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As people age they are more likely to develop chronic conditions and will tend to be on multiple medications for long periods of time to manage those conditions. Some of these medications have side effects that are anticholinergic in nature. These side effects can impact different parts of the body including the central nervous system. As people enter their later years the permeability of the blood brain barrier increases, increasing their risk of these kinds of side effects.

Thesis (M.Pharm.) -- University of Limpopo, 2022 / Pharmacy Dispensing Units (PDUs) are automated medicine dispensing systems, which are the first of its kind in South Africa and are operational in the public healthcare sector. At present, the application of automated dispensing technology is still evolving, and it is uncertain how it will impact on pharmacy services and be integrated into different healthcare systems. Aim To determine the attitude and experiences of patients collecting their chronic care medications at various Pharmacy Dispensing Units. Methods A cross-sectional quantitative design using a structured self-administered questionnaire was used to collect data from the participants at three PDU sites; Alexandra Plaza, Ndofaya Mall and Bara Mall. The study encompassed chronic stable patients. Participants were selected based on a simple random sampling method and included 624 participants. The study period was over two months. The researcher recorded the information that was present in the study population, and no variables were manipulated. Data was analysed using the SPSS version 27.0.0. Chi Square Tests, One-way Anova Tests and Microsoft Excel were used to analyze the data. Results Since p<0.05, the results showed that there was an association between responses and demographic information. The difference in distribution of responses seen across the participants at the different PDUs was significant. Most participants (85,4%) found the ATM easy to use as it was a simple system. Majority of the participants (99,6%) were content with the overall service received at the PDU, and 99,3% were pleased with the experience they had speaking through the PDU telephonic system. In comparison to the clinic, 99% of the participants felt they preferred to use the PDU and 99,7% found the PDU system easier to collect their medication from and follow their treatment plan. A few participants (2,7%) did have some negative experiences such as the system being down, network issues, technical challenges, delivery problems and the PDU being too busy. However, all of the respondents stated that they would recommend the PDU to other patients, as well as continue to collect their medicines at the PDU. Conclusion Overall patients had a positive attitude and experience towards the PDU. This research will assist in ensuring pharmacies continue to shift their focus to providing a more holistic approach to healthcare. It will allow for engagement with National and Provincial Departments of Health and NGOs to expand the number of PDUs. Furthermore, it might also help to develop new services and allow for changes to be made within the current models. This study will contribute to the overall improvement in the health sector and prepare for implementation of NHI. / VLIR Foundation

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Improving the safety of medicines management when people leave hospital is an international priority. There is evidence that poor co-ordination of medicines between providers can cause preventable harm to patients, yet there is insufficient evidence of the structure and function of the medicines management system that patients experience. This research used a mixed-methods social network analysis to determine the structure, content and function of that system as experienced by patients. Patients’ networks comprised a range of loosely connected healthcare professionals in different organisations and informal, personal contacts. Networks performed multiple functions, including health condition management, and orienting patients concerning their medicines. Some patients experienced safety incidents as a function of their networks. Staff discharging patients from hospital were also observed. Contributory factors that were found to risk the safety of patients’ discharge with medicines included active failures, individual factors and local working conditions. System defences involving staff and patients were also observed. The study identified how patients often co-ordinated a system that lacked personalisation and there is a need to provide more consistent support for patients’ self-management of medicines after they leave hospital. This could be achieved through interventions that include patients’ informal contacts in supporting their medicines use, enhancing their resilience to preventable harm, and developing and testing the role of a ‘medicines key worker’ in safely managing the transfer of care. The role of GP practices in co-ordinating the involvement of multiple professionals in patient polypharmacy needs to be further explored. / University of Bradford studentship

Abstract ECONOMIC IMPACT OF WASTE IN PRESCRIBING, DISPENSING, AND MEDICATION CONSUMPTION IN THE UNITED STATES By Sarah A. Almanie, M.S. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University. Virginia Commonwealth University, 2015. Major Director: David A. Holdford, R.Ph., M.S., Ph.D., FAPhA Professor Department of Pharmacotherapy and Outcomes Science OBJECTIVES: This research examines waste associated with the medication use process which consists of unfilled prescriptions, abandoned prescriptions, or unused prescription medications. The aim of this study is to quantify the direct medical costs of medication waste in delivery of care in the United States. METHODS: A review of published literature and data from the 2012 Medical Expenditure Panel Survey was used to quantify the number of prescriptions wasted at different stages of the medication prescribing and use process and the associated costs were calculated. RESULTS: In 2012, more than 26 million prescriptions were either unfilled or abandoned, and more than 225 million resulted in dispensed medications that were not used. The total cost of this waste was estimated at $30.4 billion. CONCLUSIONS: Patients who do not fulfill their role in the medication use process cause significant, avoidable costs to the health care system beyond the health outcomes not achieved.