Magister Pharmaceuticae - MPharm / Tuberculosis and mv
Tuberculosis (TB) is a major contributor to the disease burden in developing countries
resulting in the deaths of approximately 2 million people a year. South Africa (SA) has one (
of the highest annual TB incidences with an estimate of 558 per 100 000 population
(2003) and the situation shows no sign of abating. TB remains the most common
opportunistic infection and cause of death amongst HIV- infected patients. Both TB and
HIV treatment depends exclusively on multi-drug regimens that require close monitoring
among health care professionals.
With increasing workload due to staff shortage and high patient load, the quality of care
in nurse-led primary care clinics may be compromised. Existing clinic staff may overlook
drug-drug interactions, side effects and may not be aware of the consequences when a
formulation is modified during multi-drug therapy administration.
As the custodian of medicines, pharmacists are ideally placed to monitor therapy. Clinic-based
training programs that are offered to nurses provide an opportunity to work
alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic
the outcome of TB and HIV drug regimens could be closely monitored.
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Aims
The primary and secondary aims of the study were to:
• Assess current practice patterns of TBIHIV at primary healthcare clinics in the
Western Cape,
• Assess the need for a clinic-based TBIHIV training among final year pharmacy
students in UWC.
http://uwc.ac.za
Objectives
To achieve the primary aim the researcher;
1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to
assess current TBIHIV practice among HCP's and co-infected patients,
2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB
clinic (pre-intervention),
3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use
by pharmacists at Delft South and Elsies River clinics (intervention phase),
4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South
and Elsies River clinics (post-intervention phase).
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To achieve the secondary aim the researcher;
5. Introduced a clinic-based training for seven final year pharmacy students,
6. Designed and administered an assessment to both control and experimental students,
7. Assessed scores between students who received the training (experimental group) with those who did not receive the training (control group).
Results and discussion
Findings from the baseline study indicate the need for the involvement of a trained
pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the
patients preferred receiving their TB information from the clinic nurse, almost two-thirds
(63.2%; 12) of the patients believed that pharmacists assisted with their treatment
provision.
Patient data obtained from the clinic record card showed that almost two-thirds of the
patients reported that they had experienced side effects (64.4%); the therapy of more than
one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %).
Post-intervention, the data showed that patients' viewed the pharmacist's role more
positively. Almost all responses (97.5%; 39) favored the services of a pharmacist in the
clinic. In conclusion, findings from the post-intervention patient study underpin
that a clinic-based role for the pharmacist is imminent.
All seven (100%) of the experimental students passed the assessment and had scores in
the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control
students passed with marks within this range.
Conclusion
A trained pharmacist would be competent to work alongside nursing staff in optimizing
care provision in the clinical management of TB and HIV in patients. The existing clinic-based
TB/HIV program could be supplemented with theoretical concepts in the final
year of undergraduate pharmacy training.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uwc/oai:etd.uwc.ac.za:11394/8509 |
| Date | January 2010 |
| Contributors | Tokosi, Oluwatoyin Iyabode Abiola |
| Publisher | University of the Western Cape |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Rights | University of the Western Cape |
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