Theses and Dissertations (Pharmacy)
http://hdl.handle.net/10386/62
2024-03-29T13:40:51ZEvaluation of antiretroviral use in children managed in public clinics of Mopani District, Limpopo Province : towards a dosing and dispensing training programme for nurses
http://hdl.handle.net/10386/4162
Evaluation of antiretroviral use in children managed in public clinics of Mopani District, Limpopo Province : towards a dosing and dispensing training programme for nurses
Mabila, Linneth Nkateko
Antiretroviral (ARV) management in children is considered a challenging process, and
patients receiving ARVs remain at risk of medication errors. Recently, there has also
been a noticeable increase in Treatment Failure (TF) and the development of drug
resistance amongst children on ART. However, ART failure amongst children seems
to be an under-recognised issue, and adherence to treatment guidelines is reported
to be a challenge among nurses caring for People Living with HIV (PLWHIV). Hence,
the aim of this study was to explore the prescribing practices, and to determine the
knowledge, understanding, and competence levels of NIMART-trained nurses’ in the
management of children on Antiretroviral Therapy (ART) in Public Health Care (PHC)
facilities located in a rural district of Limpopo Province. To attain the purpose of the
study, the researcher in this study adopted a mixed-method, in an explanatory
sequential manner. The quantitative phase adopted a descriptive cross-sectional and
retrospective census of medical records to determine whether or not the children on
ART were prescribed the correct ARV regimen, dose, strength, dosing frequency and
received the correct quantities to last until the next appointment date. Whereas the
qualitative phase embraced a total purposive sampling of the NIMART-trained
professional nurses to explore their knowledge, understanding and views of ART
management in children. The results highlighted that these children under study even
though they were prescribed a correct ARV regimen in (n=7045; 96%) of the
cases;they were only correctly dosed in (n=7797; 53%); and prescribed the correct
strength (n=9539; 77%), with only (n=2748; 36.9%) having received the correct
quantity of treatment to last them until the next appointment date. Most nurses even
though they rated themselves very knowledgeable and competent in paediatric
HIV/AIDS management. This finding was contradicting the results obtained from the
medical records, as well as their responses to the given case scenario depicted some
level of non-adherence to treatment guidelines as well as a lack of understanding of
ARV management. From the findings of this ARV utilisation review and the
implementation of the developed ART dosing and dispensing training programme. The
study concludes that the nurse's prescribing practice was irrational in this cohort of
children, and most prescriptions did not entirely comply with the 2014/15 HIV/AIDs treatment recommendations. Since, this cohort of children was found to be susceptible
to medication related errors such as; Drug omissions in ARV regimens; Incorrect
dosing & dosing frequencies; as well as incorrectly supplied quantities. From the study
findings it is recommended that ARV stewardship programs should be considered in
order to develop and establish a core strategy for enhancing quality improvement in
the management of HIV-infected children on ART in resource-limited settings, not only
to inundate viral suppression and maintain it, but also to help achieve the UNAIDS 95-
95-95 target in children under 15 year
Thesis (Ph.D. (Pharmacy)) -- University of Limpopo, 2022
2022-01-01T00:00:00ZExploring pharmacist-medical practitioner collaboration on outpatient pharmaceutical care at Mankweng Hospital in Limpopo Province, South Africa
http://hdl.handle.net/10386/4111
Exploring pharmacist-medical practitioner collaboration on outpatient pharmaceutical care at Mankweng Hospital in Limpopo Province, South Africa
Bopape, Mack Stumpu
Developing countries face huge challenges in provision of pharmaceutical care whereas some developed countries have developed and implemented measure to improve pharmaceutical care through collaborative practices. Collaborative patient care is referred to as the cooperative work or practice by healthcare professionals assuming complementary roles and sharing responsibilities for decision making and problem solving to formulate and furnish quality patient care. Pharmaceutical care is governed by the principles and philosophy of patient centred pharmacy practice, where the main responsibilities, roles or action of a pharmacist are based on patient care. Collaborative pharmaceutical care practice for outpatient requires collaborative action of a pharmacist with other healthcare practitioners. Pharmacist-medical practitioner collaborative care practice is one of the recently emerging aspects in developing countries’ hospitals such as in South Africa which can enhance patient care.
Method
A qualitative study using semi-structured interviews was conducted with a purposeful sample of 8 pharmacists and 9 medical practitioners at Mankweng Hospital in Limpopo province, South Africa. In the study we used audiotaped interviews that were transcribed exactly as said and analysed using thematic content analysis.
Results
Three main themes emerged from the study’s interview analysis, description of the current relationship and collaborative practices; the perspective of the pharmacists and medical practitioners on collaboration; the barriers affecting pharmacist-medical practitioner collaboration; and recommendations on the ways, strategy and model to improve pharmacists-medical practitioner collaboration. This highlighted that the relationship among pharmacists and medical practitioners is moderate and there a need for improvement in the relationship. The recommendations range from established
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educational and interactional platforms, improved resource supply, clarity in terms of roles and responsibilities and enhanced managerial structures and functions.
Conclusion
The current relationship among pharmacists and medical practitioners is moderate. There is still a need for improvement in the relationship to achieve quality collaborative practice for pharmaceutical care in outpatient.
Thesis (M.Pharm. (Pharmacy Practice)) -- University of Limpopo, 2022
2022-01-01T00:00:00ZPatients'attitides and experiences towards automated pharmacy dispensing units in Johannesburg, South Africa
http://hdl.handle.net/10386/4014
Patients'attitides and experiences towards automated pharmacy dispensing units in Johannesburg, South Africa
Chouhan, Hethel
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.
Thesis (M.Pharm.) -- University of Limpopo, 2022
2022-01-01T00:00:00ZFormulation and evaluation of amorphous clarithromycin tablets for enhanced dissolution
http://hdl.handle.net/10386/3892
Formulation and evaluation of amorphous clarithromycin tablets for enhanced dissolution
Mongalo, Sello Herlot
According to the biopharmaceutical classification system, Clarithromycin is
considered a class II molecule with low solubility. Poorly soluble drugs result in low
bioavailability. Various techniques have been studied to improve the solubility of
drugs and subsequently bioavailability. Of these techniques, preparation of
amorphous form is the preferred method because it is a more effortless and
convenient way to improve the aqueous solubility and dissolution of poorly water soluble drugs. The only disadvantage of amorphous materials is that they are less
thermodynamically stable and can recrystallize during processing and storage.
Aim:
The aim of this study is to prepare amorphous form of clarithromycin to improve its
solubility, dissolution rate, and, subsequently, bioavailability.
Methods:
In this study, preparation of amorphous form of clarithromycin was conducted using
the quench cooling method in which the purchased anhydrous crystalline
clarithromycin was spread on an aluminum foil and heated to a melting point (217˚C
- 220˚C) and then rapidly cooled. Various techniques were conducted to
characterize the prepared amorphous clarithromycin, and these include Differential
Scanning Calorimetry (DSC), Fourier-Transform Infrared Spectroscopy (FTIR), and
X-Ray Powder Diffraction (XRPD). In addition, tablets were formulated using the
amorphous clarithromycin mixed with selected excipients from compatibility studies,
and in vitro dissolution and stability studies were conducted over a period of 6
months.
Results:
The DSC thermogram results confirmed that the material prepared using the
quench cooling process is an amorphous solid-state. Furthermore, the XRPD
confirmed an amorphous solid-state with scattering halo peaks. The FTIR also
depicted some broader and lower intensity peaks that indicated a formation of an
amorphous material. The dissolution rate of amorphous clarithromycin tablets
improved by more than 30% when compared to commercial crystalline
clarithromycin tablets. The study revealed a drop in dissolution rate at months 3 to
6 under accelerated conditions due to recrystallization. The 6 monthly stability study
at long term conditions showed no change in the integrity of the tablets and their
contents.
Conclusion:
As indicated by the study, it can be concluded that the amorphous clarithromycin
remained stable during processing and storage under long-term stability for 6
months. Furthermore, based on dissolution results, it can be concluded that
amorphous solids have an improved dissolution rate.
Thesis (M. Pharmacy ((Pharmaceutics)) -- University of Limpopo, 2022
2022-01-01T00:00:00Z