Angeni Bheekie - Academia.edu (original) (raw)
Papers by Angeni Bheekie
Pharmacy, Oct 8, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The pharmacists’ role in the healthcare system is expanding internationally beyond the traditiona... more The pharmacists’ role in the healthcare system is expanding internationally beyond the traditional roles of compounding and medicine supply management, to providing patient-centred care and updating health care workers on relevant medicine therapies. 1 Pharmacists are pivotal in meeting the medicine-related needs of patients and other health care professionals. Even though pharmacists will remain responsible for medicine supply management, the routine activities associated with this can be handled by qualified pharmacist’s assistants and/or pharmacy technicians, while allowing pharmacists to embark on pharmaceutical care, identifying and solving the risks associated with medicine use and therapeutic drug monitoring. 2 With an increase in the development of new medicines, it has become imperative for pharmacists to be integral members of the multidisciplinary team in order to ensure rational use of these medicines. 3 Patient safety with the use of medicines have become a global conce...
South African Medical Journal, 2022
Background. Diabetes mellitus (DM) is a complex chronic condition and remains a public health con... more Background. Diabetes mellitus (DM) is a complex chronic condition and remains a public health concern worldwide. In South Africa (SA), many patients with DM access public sector primary healthcare clinics, and those who are considered to be stable are referred to the club system, which is managed by a multidisciplinary team. Patients who have DM are often diagnosed with concurrent medical conditions, resulting in multiple medication therapies that lead to medication therapy problems (MTPs). Prescriber adherence to standard treatment guidelines (STGs) is aimed at improving glycaemic control to minimise complications and decrease healthcare costs. The pharmacist’s role in medication therapy management (MTM) for DM is underutilised in public sector healthcare facilities. Objectives. To evaluate the implementation of a pharmacist-led MTM intervention to optimise the management of stable patients with type 2 DM attending a diabetes club at a Cape Town community day centre. Methods. An ev...
Journal of Physical Activity and Health, 2017
Global health education reform requires training institutions to align their education, service a... more Global health education reform requires training institutions to align their education, service and research activities with the values of social accountability, which include relevance, equity, quality and effectiveness. The alignment with these values aims to ensure graduates who are competent to meet society's priority health needs, especially those of marginalised and underserved communities. This study aimed to qualitatively assess the alignment of activities of the nine South African pharmacy schools with the values of social accountability from information and evidence available in the public domain. Data were collected from pharmacy schools' websites, and related publications and newsletters. Information was grouped into predetermined categories representing the different values of social accountability. A scoring rubric was adapted that assessed the alignment of the information and evidence collected to the values of relevance equity and quality. Each pharmacy school's information was initially reviewed and scored by three independent reviewers. Each of the reviewers cross-checked each other's allocated scores and any variations in scores were settled via consensus between the reviewers. The information of six pharmacy schools was assessed. For relevance, pharmacy schools scored over 50% and above for all their activities. For equity, schools showed most variation in their educational activities, and least variation in their service activities. For quality, schools showed most consistency with education and service activities but most variation occurred in the quality of services. Information from the public domain may be useful in assessing social accountability. The depth of information that schools could share publicly remains a key question.
African Journal of Health Professions Education, 2019
South African Pharmaceutical Journal, Mar 1, 2019
This paper describes the community health clinic rotation of the Patient Care Experience programm... more This paper describes the community health clinic rotation of the Patient Care Experience programme (PaCE) offered to fourth year pharmacy students (2018) at the University of the Western Cape. Reflections from the collective experiences of the faculty and practice preceptors offer insight into integration of a clinicallyoriented medicine therapy management programme directed at the primary care level.
Pharmacy
Reducing maternal and child mortality is a health priority in South Africa. Therefore, health pro... more Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A one-sample t-test showed ...
Journal of Clinical Pharmacy and Therapeutics, 2001
To compare the use of patient-performed peak expiratory flow (PEFR) and symptom monitoring as ast... more To compare the use of patient-performed peak expiratory flow (PEFR) and symptom monitoring as asthma self-management tools initiated from community pharmacies. 110 patients over 6 years of age were recruited from five private-sector community pharmacies. Patients were identified from pharmacist recall as having 'asthma'. Information on the frequency of their asthma symptoms, medication use, level of physical activity, school or work attendance and lung function was obtained using a questionnaire to classify patients as either mild, moderate or severe. Each patient was alternately assigned to either the symptom or PEFR monitoring procedure in the order they were recruited. Patients performing symptom monitoring used a visual analogue scale to assess symptoms, whereas those in the PEFR monitoring group assessed symptoms and used a pocket-size peak flow meter to measure lung function. Both self-monitoring groups were required to adhere to an individualized management plan based on guideline recommendations and to record their monitored data in a diary card for 2 months. Data from the diary cards were reviewed, collated, transcribed and analysed using the Student t and Mann-Whitney tests. The average monthly frequency of appropriate patient responses determined from their adherence to the self-management plan was used to compare the usefulness of symptom and PEFR self-monitoring. In particular, appropriate use of medication and need for medical consultation was compared. 21 symptom and 40 PEFR-assigned patients completed 2 months' monitoring. The average monthly frequency of appropriate responses in patients using PEFR (0.76) was significantly higher than that of patients using symptom monitoring (0.53, P < 0.006). Patients applying symptom monitoring had a higher monthly frequency (0.39) of inappropriate medication use compared to the PEFR group (0.14). Furthermore, the patients' mean daily symptom scores (2.85) were significantly lower than that estimated by the researcher (4.12, P < 0.03). For all three asthma severity groups a higher monthly average of appropriate responses was observed in patients using PEFR monitoring compared to those who used symptom monitoring. PEFR self-monitoring proved to be a more useful asthma tool than symptom self-monitoring. Patients applying symptom monitoring tend to underestimate the severity of their condition and use medication inappropriately. Active involvement of community pharmacists in facilitating and reinforcing out-patient self-monitoring would help to optimize asthma management.
Pharmacy
Reducing maternal and child mortality is a health priority in South Africa. Therefore, health pro... more Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A one-sample t-test showed ...
Additional file 1. Questionnaire used for data collection in the study
<b>Copyright information:</b>Taken from "Educational outreach to general practit... more <b>Copyright information:</b>Taken from "Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial"http://www.implementationscience.com/content/2/1/30Implementation science : IS 2007;2():30-30.Published online 24 Sep 2007PMCID:PMC2200659.
<b>Copyright information:</b>Taken from "Diagnostic accuracy of an integrated re... more <b>Copyright information:</b>Taken from "Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study"BMC Pulmonary Medicine 2006;6():22-22.Published online 25 Aug 2006PMCID:PMC1569870.
SA Pharmaceutical Journal, 2006
This article provides an overview of service-learning concepts, its implementation at the School ... more This article provides an overview of service-learning concepts, its implementation at the School of Pharmacy at UWC, and highlights the way forward towards consolidation of the programme.
International Journal of Research on Service-Learning and Community Engagement, 2016
Social justice underpins the sustainable development goal of health for all. In developing countr... more Social justice underpins the sustainable development goal of health for all. In developing countries, social injustices are particularly severe and widespread, demanding critical and immediate attention. This article describes a qualitative, descriptive study that investigated pharmacy students' responses to incidents of social injustice following their service-learning experiences in public-sector primary healthcare facilities in Cape Town, South Africa. Data were gathered from written reflection reports and then thematically analyzed using the pedagogy of discomfort as an interpretive framework. Themes were categorised according to students' habitual responses to incidents of social injustice, how they interpreted their responses, and how they could promote social justice in the workplace as future healthcare professionals. Findings demonstrated students' inability to take action and revealed that silence was the most common response to incidents of discrimination. These results highlight the ways in which the structural constraints of the societal status quo can perpetuate inequity. Study limitations include bias from students self-reports and their narrow understanding of structural barriers in the workplace. Intergenerational dialogue and advocacy is crucial across South African higher education to understand widespread social injustices. Embedding a critical approach to service-learning in the African context needs exploration.
Background Community Engagement (CE) is cornerstone to South Africa’s higher education transforma... more Background Community Engagement (CE) is cornerstone to South Africa’s higher education transformative agenda. Teaching disciplines across faculties have adopted varied CE implementation strategies, due to different theoretical interpretations. Undergraduate health science students are traditionally exposed to CE experiential learning programs, preparing them for professional practice. This study investigated final year students’ awareness of the critical factors which shape CE in the health science disciplines at a South African university.Method An exploratory descriptive qualitative study was conducted at an engaged university located in the Western Cape. Five discipline- specific focus group discussions were conducted with twenty seven final year students, purposively selected from five health sciences faculties, using an adaption of Furco’s self-assessment rubric. Thematic analysis was conducted on the transcribed data to identify the factors deemed critical for CE using Furco’s...
BMC Health Services Research, 2008
Background: South Africa recently launched a national antiretroviral treatment programme. This ha... more Background: South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). Methods: Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. Results: Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context.
Pharmacy, Oct 8, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The pharmacists’ role in the healthcare system is expanding internationally beyond the traditiona... more The pharmacists’ role in the healthcare system is expanding internationally beyond the traditional roles of compounding and medicine supply management, to providing patient-centred care and updating health care workers on relevant medicine therapies. 1 Pharmacists are pivotal in meeting the medicine-related needs of patients and other health care professionals. Even though pharmacists will remain responsible for medicine supply management, the routine activities associated with this can be handled by qualified pharmacist’s assistants and/or pharmacy technicians, while allowing pharmacists to embark on pharmaceutical care, identifying and solving the risks associated with medicine use and therapeutic drug monitoring. 2 With an increase in the development of new medicines, it has become imperative for pharmacists to be integral members of the multidisciplinary team in order to ensure rational use of these medicines. 3 Patient safety with the use of medicines have become a global conce...
South African Medical Journal, 2022
Background. Diabetes mellitus (DM) is a complex chronic condition and remains a public health con... more Background. Diabetes mellitus (DM) is a complex chronic condition and remains a public health concern worldwide. In South Africa (SA), many patients with DM access public sector primary healthcare clinics, and those who are considered to be stable are referred to the club system, which is managed by a multidisciplinary team. Patients who have DM are often diagnosed with concurrent medical conditions, resulting in multiple medication therapies that lead to medication therapy problems (MTPs). Prescriber adherence to standard treatment guidelines (STGs) is aimed at improving glycaemic control to minimise complications and decrease healthcare costs. The pharmacist’s role in medication therapy management (MTM) for DM is underutilised in public sector healthcare facilities. Objectives. To evaluate the implementation of a pharmacist-led MTM intervention to optimise the management of stable patients with type 2 DM attending a diabetes club at a Cape Town community day centre. Methods. An ev...
Journal of Physical Activity and Health, 2017
Global health education reform requires training institutions to align their education, service a... more Global health education reform requires training institutions to align their education, service and research activities with the values of social accountability, which include relevance, equity, quality and effectiveness. The alignment with these values aims to ensure graduates who are competent to meet society's priority health needs, especially those of marginalised and underserved communities. This study aimed to qualitatively assess the alignment of activities of the nine South African pharmacy schools with the values of social accountability from information and evidence available in the public domain. Data were collected from pharmacy schools' websites, and related publications and newsletters. Information was grouped into predetermined categories representing the different values of social accountability. A scoring rubric was adapted that assessed the alignment of the information and evidence collected to the values of relevance equity and quality. Each pharmacy school's information was initially reviewed and scored by three independent reviewers. Each of the reviewers cross-checked each other's allocated scores and any variations in scores were settled via consensus between the reviewers. The information of six pharmacy schools was assessed. For relevance, pharmacy schools scored over 50% and above for all their activities. For equity, schools showed most variation in their educational activities, and least variation in their service activities. For quality, schools showed most consistency with education and service activities but most variation occurred in the quality of services. Information from the public domain may be useful in assessing social accountability. The depth of information that schools could share publicly remains a key question.
African Journal of Health Professions Education, 2019
South African Pharmaceutical Journal, Mar 1, 2019
This paper describes the community health clinic rotation of the Patient Care Experience programm... more This paper describes the community health clinic rotation of the Patient Care Experience programme (PaCE) offered to fourth year pharmacy students (2018) at the University of the Western Cape. Reflections from the collective experiences of the faculty and practice preceptors offer insight into integration of a clinicallyoriented medicine therapy management programme directed at the primary care level.
Pharmacy
Reducing maternal and child mortality is a health priority in South Africa. Therefore, health pro... more Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A one-sample t-test showed ...
Journal of Clinical Pharmacy and Therapeutics, 2001
To compare the use of patient-performed peak expiratory flow (PEFR) and symptom monitoring as ast... more To compare the use of patient-performed peak expiratory flow (PEFR) and symptom monitoring as asthma self-management tools initiated from community pharmacies. 110 patients over 6 years of age were recruited from five private-sector community pharmacies. Patients were identified from pharmacist recall as having 'asthma'. Information on the frequency of their asthma symptoms, medication use, level of physical activity, school or work attendance and lung function was obtained using a questionnaire to classify patients as either mild, moderate or severe. Each patient was alternately assigned to either the symptom or PEFR monitoring procedure in the order they were recruited. Patients performing symptom monitoring used a visual analogue scale to assess symptoms, whereas those in the PEFR monitoring group assessed symptoms and used a pocket-size peak flow meter to measure lung function. Both self-monitoring groups were required to adhere to an individualized management plan based on guideline recommendations and to record their monitored data in a diary card for 2 months. Data from the diary cards were reviewed, collated, transcribed and analysed using the Student t and Mann-Whitney tests. The average monthly frequency of appropriate patient responses determined from their adherence to the self-management plan was used to compare the usefulness of symptom and PEFR self-monitoring. In particular, appropriate use of medication and need for medical consultation was compared. 21 symptom and 40 PEFR-assigned patients completed 2 months' monitoring. The average monthly frequency of appropriate responses in patients using PEFR (0.76) was significantly higher than that of patients using symptom monitoring (0.53, P < 0.006). Patients applying symptom monitoring had a higher monthly frequency (0.39) of inappropriate medication use compared to the PEFR group (0.14). Furthermore, the patients' mean daily symptom scores (2.85) were significantly lower than that estimated by the researcher (4.12, P < 0.03). For all three asthma severity groups a higher monthly average of appropriate responses was observed in patients using PEFR monitoring compared to those who used symptom monitoring. PEFR self-monitoring proved to be a more useful asthma tool than symptom self-monitoring. Patients applying symptom monitoring tend to underestimate the severity of their condition and use medication inappropriately. Active involvement of community pharmacists in facilitating and reinforcing out-patient self-monitoring would help to optimize asthma management.
Pharmacy
Reducing maternal and child mortality is a health priority in South Africa. Therefore, health pro... more Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A one-sample t-test showed ...
Additional file 1. Questionnaire used for data collection in the study
<b>Copyright information:</b>Taken from "Educational outreach to general practit... more <b>Copyright information:</b>Taken from "Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial"http://www.implementationscience.com/content/2/1/30Implementation science : IS 2007;2():30-30.Published online 24 Sep 2007PMCID:PMC2200659.
<b>Copyright information:</b>Taken from "Diagnostic accuracy of an integrated re... more <b>Copyright information:</b>Taken from "Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study"BMC Pulmonary Medicine 2006;6():22-22.Published online 25 Aug 2006PMCID:PMC1569870.
SA Pharmaceutical Journal, 2006
This article provides an overview of service-learning concepts, its implementation at the School ... more This article provides an overview of service-learning concepts, its implementation at the School of Pharmacy at UWC, and highlights the way forward towards consolidation of the programme.
International Journal of Research on Service-Learning and Community Engagement, 2016
Social justice underpins the sustainable development goal of health for all. In developing countr... more Social justice underpins the sustainable development goal of health for all. In developing countries, social injustices are particularly severe and widespread, demanding critical and immediate attention. This article describes a qualitative, descriptive study that investigated pharmacy students' responses to incidents of social injustice following their service-learning experiences in public-sector primary healthcare facilities in Cape Town, South Africa. Data were gathered from written reflection reports and then thematically analyzed using the pedagogy of discomfort as an interpretive framework. Themes were categorised according to students' habitual responses to incidents of social injustice, how they interpreted their responses, and how they could promote social justice in the workplace as future healthcare professionals. Findings demonstrated students' inability to take action and revealed that silence was the most common response to incidents of discrimination. These results highlight the ways in which the structural constraints of the societal status quo can perpetuate inequity. Study limitations include bias from students self-reports and their narrow understanding of structural barriers in the workplace. Intergenerational dialogue and advocacy is crucial across South African higher education to understand widespread social injustices. Embedding a critical approach to service-learning in the African context needs exploration.
Background Community Engagement (CE) is cornerstone to South Africa’s higher education transforma... more Background Community Engagement (CE) is cornerstone to South Africa’s higher education transformative agenda. Teaching disciplines across faculties have adopted varied CE implementation strategies, due to different theoretical interpretations. Undergraduate health science students are traditionally exposed to CE experiential learning programs, preparing them for professional practice. This study investigated final year students’ awareness of the critical factors which shape CE in the health science disciplines at a South African university.Method An exploratory descriptive qualitative study was conducted at an engaged university located in the Western Cape. Five discipline- specific focus group discussions were conducted with twenty seven final year students, purposively selected from five health sciences faculties, using an adaption of Furco’s self-assessment rubric. Thematic analysis was conducted on the transcribed data to identify the factors deemed critical for CE using Furco’s...
BMC Health Services Research, 2008
Background: South Africa recently launched a national antiretroviral treatment programme. This ha... more Background: South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). Methods: Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. Results: Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context.