Different models of pharmaceutical services and care in primary healthcare clinics in the Eastern Cape, South Africa: Challenges and opportunities for pharmacy practice.
Ambulatory Care Facilities
/ organization & administration
Clinical Audit
Health Services Accessibility
Humans
Models, Organizational
National Health Programs
Patient-Centered Care
/ organization & administration
Pharmaceutical Services
/ organization & administration
Pharmacists
/ supply & distribution
Primary Health Care
/ organization & administration
South Africa
dispensing models
pharmaceutical care
pharmaceutical services
primary health care re-engineering
task-shifting
Journal
African journal of primary health care & family medicine
ISSN: 2071-2936
Titre abrégé: Afr J Prim Health Care Fam Med
Pays: South Africa
ID NLM: 101520860
Informations de publication
Date de publication:
27 Jul 2020
27 Jul 2020
Historique:
received:
14
12
2019
accepted:
22
04
2020
revised:
01
04
2020
entrez:
14
8
2020
pubmed:
14
8
2020
medline:
28
5
2021
Statut:
epublish
Résumé
Primary health care (PHC) re-engineering forms a crucial part of South Africa's National Health Insurance (NHI), with pharmaceutical services and care being crucial to treatment outcomes. However, owing to a shortage of pharmacists within PHC clinics, task-shifting of the dispensing process to pharmacist's assistants and nurses is common practice. The implications of this task-shifting process on the provision of pharmaceutical services and care remains largely unstudied. The study aimed to explore the pharmacist-based, pharmacist's assistant-based and nurse-based dispensing models within the PHC setting. The Nelson Mandela Bay Health District, South Africa. A mixed methods approach was utilised comprising of Phase 1: a pharmaceutical services audit to analyse pharmaceutical service provision and Phase 2: semi-structured interviews to describe the pharmaceutical care provision within each dispensing model thematically. Pharmaceutical services partially fulfilled minimum standards within all models, however, challenges exist that limit the quality of these services. Phase 2 showed that the provision of pharmaceutical care within all models was restricted by context-related constraints, thus patient-centred activities to underpin pharmaceutical services were limited. Although pharmaceutical services may have been available for all models, compromised quality of these services impacted overall quality of care. Limited pharmaceutical care provision was evident within each dispensing model. The results raised concerns about the current utilisation of pharmacy personnel, including the pharmacist, within the PHC setting. Further opportunities exist, if constraints allow, for the pharmacist to contribute to better patient-centred care.
Sections du résumé
BACKGROUND
BACKGROUND
Primary health care (PHC) re-engineering forms a crucial part of South Africa's National Health Insurance (NHI), with pharmaceutical services and care being crucial to treatment outcomes. However, owing to a shortage of pharmacists within PHC clinics, task-shifting of the dispensing process to pharmacist's assistants and nurses is common practice. The implications of this task-shifting process on the provision of pharmaceutical services and care remains largely unstudied.
AIM
OBJECTIVE
The study aimed to explore the pharmacist-based, pharmacist's assistant-based and nurse-based dispensing models within the PHC setting.
SETTING
METHODS
The Nelson Mandela Bay Health District, South Africa.
METHODS
METHODS
A mixed methods approach was utilised comprising of Phase 1: a pharmaceutical services audit to analyse pharmaceutical service provision and Phase 2: semi-structured interviews to describe the pharmaceutical care provision within each dispensing model thematically.
RESULTS
RESULTS
Pharmaceutical services partially fulfilled minimum standards within all models, however, challenges exist that limit the quality of these services. Phase 2 showed that the provision of pharmaceutical care within all models was restricted by context-related constraints, thus patient-centred activities to underpin pharmaceutical services were limited.
CONCLUSION
CONCLUSIONS
Although pharmaceutical services may have been available for all models, compromised quality of these services impacted overall quality of care. Limited pharmaceutical care provision was evident within each dispensing model. The results raised concerns about the current utilisation of pharmacy personnel, including the pharmacist, within the PHC setting. Further opportunities exist, if constraints allow, for the pharmacist to contribute to better patient-centred care.
Identifiants
pubmed: 32787403
doi: 10.4102/phcfm.v12i1.2323
pmc: PMC7433309
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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