Hazel Bradley - Academia.edu (original) (raw)

Papers by Hazel Bradley

Research paper thumbnail of Study participants’ characteristics

Research paper thumbnail of Frontline managers interview guide

Research paper thumbnail of Global access to quality-assured medical products: the Oxford Statement and call to action

The Lancet Global Health, 2019

Research paper thumbnail of Roles

Research paper thumbnail of COREQ 32 checklist

Research paper thumbnail of Frontline managers quotes

Research paper thumbnail of Assessment of the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia

Background The irrational use of medicines, and increasingly antimicrobials, remains a key health... more Background The irrational use of medicines, and increasingly antimicrobials, remains a key health problem in many developing countries including Zambia. Inappropriate, ineffective and inefficient use of medicines is common in health facilities at all levels. There are many factors influencing irrational prescribing and dispensing of antimicrobials including patients, prescribers, dispensers, the supply system (including industry influences), government regulations and medicines information and misinformation. Study aim The aim of the study was to assess the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia. Study design The study was a cross-sectional descriptive study, with prospective and retrospective components. A standardized research methodology, including tools and indicators, adapted from the World Health Organization, was employed. Study population and sampling The study population included all the 30 government primary level health facilities (health centres) in Lusaka District, from which 20 primary health facilities were sampled using a combination of purposive and random sampling. Using the WHO standard indicators of rational drug use, this study assessed 800 patient encounters, 520 medicines inventory records, and other baseline data, from 20 health facilities at three different levels under the Lusaka district community health office, Zambia. Data collection The data collection tools were numbered and labeled. Tool 1: Prescribing Indicator Form was used to collect prescribing data; Tool 2: Patient Care (Pharmacy) Form was used to record dispensing data; Tool 3: Antimicrobial Availability Form for recording data for the availability of the key indicator antimicrobials and their substitutes; Tool 4: Facility Indicator Consolidation Reporting Form was iv used for consolidating the data collected for each health facility under study; and Tool 5: Facility Medicines Use Indicator Consolidation Form was used for the consolidation of the drug use data for the entire study. Third year Pharmacy Technology students were trained for the data collection process. The patients were first observed from outside the prescriber's room and the dispensing area for consultation and dispensing times respectively, and then they were interviewed to collect the prescribing and dispensing data. The tools were pre-tested. Data analysis After data checking and consolidation, quantitative data were categorized into continuous numerical variables. Calculations were done manually and using computerized analysis (Epi Info package) and presented as simple frequency and means. Ethics Ethical clearance for the study was obtained from University of the Western Cape Senate Research Committee. Permission was obtained from the Lusaka Provincial and District health offices, being the authorities that are overseeing the health facilities included in the study. Furthermore, permission was obtained from the health centre in-charges. Consent was obtained from healthcare providers and patients. Key results and discussion The study found that at the primary level facilities there were more Clinical Officers (55%) than Medical Doctors (25%) and Registered Nurses (20%) in charge of prescribing. The main dispensers were Pharmacy Technologists (85%); there were no Pharmacists available in any of the facilities. A third [259 (32.4 %)] of all the 800 patients in the study were children below 12 years of age. Across the clinics, a mean of 2.94 medicines were prescribed per prescription, with an extremely low rate of prescribing drugs by generic name (36.7%). The proportion of prescriptions including an antibiotic was 36.2 % and 3.4 % included an injectable drug. Linking the antimicrobials and injections to patient diagnoses indicated that many were probably irrational, prescribing decisions. Amoxicillin and metronidazole were by far the most commonly prescribed antimicrobials at 32.0 % and 17.2 % of total antimicrobials, respectively. The essential drugs list was available in 80.0% of facilities and a high percentage of medicines were prescribed from the essential medicines list (81.2%). The overall v mean percentage of medicines packages correctly labeled was considerably low at 44.8 %. The average consultation time was short at 4.0 (range 1-8.4) minutes, whereas the dispensing times were equally short and averaged at 116.6 (range 15-360) seconds, with the range of 15 to 360 seconds. The average percentage of first line antimicrobials available at health facilities was 79 %; and the average percentage of second line, substitute, antimicrobials available was 15 %. Conclusion In line with studies from other settings, this medicines use study found considerable overuse and irrational use of antimicrobials in the primary health care clinics in Lusaka District. Irrational medicine prescribing was common and poor dispensing practices were also seen, resulting in poor use of and adherence to medicines and, consequently, poor therapeutic outcomes. Recommendations Several recommendations have been formulated. They include: Reinforcing the Drug Therapeutic Committees (DTCs) at the national and the local facility level to help manage medicines use; clarification of prescribers and dispensers roles and responsibilities; development, enforcement or adaption of standard operating procedures (SOPS) for prescribing and dispensing; and improvement of prescribing and dispensing practices through introduction of appropriate education, supervision and audit. vi DECLARATION I hereby declare that this study "ASSESSMENT OF THE RATIONAL USE AND AVAILABILITY OF ANTIMICROBIALS AT PRIMARY LEVEL HEALTH FACILITIES UNDER THE LUSAKA DISTRICT COMMUNITY HEALTH OFFICE, ZAMBIA" is my own work and it has not been submitted for any degree or examination to any other university, and that all sources I have used or quoted have been indicated and acknowledged by referencing.

Research paper thumbnail of Key informants quotes

Research paper thumbnail of Study theories and procedures

Research paper thumbnail of Key informants interview guide

Research paper thumbnail of Betabloqueantes para la hipertensión

Research paper thumbnail of How strong is the evidence for use of beta-blockers as first-line therapy for hypertension? Systematic review and meta-analysis

Journal of Hypertension, 2006

Objective To quantify the effect of first-line antihypertensive treatment with beta-blockers on m... more Objective To quantify the effect of first-line antihypertensive treatment with beta-blockers on mortality, morbidity and withdrawal rates, compared with the other main classes of antihypertensive agents. Methods We identified eligible trials by searching the Cochrane Controlled Trials Register, Medline, Embase, reference lists of previous reviews, and contacting researchers. We extracted data independently in duplicate and conducted meta-analysis by analysing trial participants in groups to which they were randomized, regardless of subsequent treatment actually received. Results Thirteen trials with 91 561 participants, meeting inclusion criteria, compared beta-blockers to placebo (four trials; n U 23 613), diuretics (five trials; n U 18 241), calcium-channel blockers (CCBs) (four trials; n U 44 825), and renin-angiotensin system (RAS) inhibitors, namely angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (three trials; n U 10 828). Compared to placebo, beta-blockers reduced the risk of stroke (relative risk 0.80; 95% confidence interval 0.66-0.96) with a marginal fall in total cardiovascular events (0.88, 0.79-0.97), but did not affect all-cause mortality (0.99, 0.88-1.11), coronary heart disease (0.93, 0.81-1.07) or cardiovascular mortality (0.93, 0.80-1.09). The effect on stroke was less than that of CCBs (1.24, 1.11-1.40) and RAS inhibitors (1.30, 1.11-1.53), and that on total cardiovascular events less than that of CCBs (1.18, 1.08-1.29). In addition, patients on beta-blockers were more likely to discontinue treatment than those on diuretics (1.80; 1.33-2.42) or RAS inhibitors (1.41; 1.29-1.54). Conclusion Beta-blockers are inferior to CCBs and to RAS inhibitors for reducing several important hard end points. Compared with diuretics, they had similar outcomes, but were less well tolerated. Hence beta-blockers are generally suboptimal first-line antihypertensive drugs.

Research paper thumbnail of A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

The International Journal of Tuberculosis and Lung Disease, 2020

INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwid... more INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: T...

Research paper thumbnail of A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

The International Journal of Tuberculosis and Lung Disease, 2020

INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwid... more INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: T...

Research paper thumbnail of Treatment Short-course (DOTS) in Mopani District of Limpopo

The purpose of the study was to assess factors contributing to poor performance of Directly Obser... more The purpose of the study was to assess factors contributing to poor performance of Directly Observed Treatment Short-Course (DOTS) in Mopani district of Limpopo Province, South Africa. An exploratory qualitative approach was used to investigate the factors that contribute to poor performance of the DOTS Strategy. Four focus group discussions were conducted, two with Directly Observed Therapy (DOT) Supporters and two with patients on treatment for more than 6 months. The focus groups (4) discussions were tape-recorded. Data collected were descriptively analyzed using thematic methods. The patients generally found supervision of TB treatment helpful as they were motivated and encouraged to continue treatment. Some of the aspects identified as being unhelpful were the inconvenient times for treatment support and stigma due TB supporters ’ visit to patients home. Patients often preferred family members as supporters, whereas health workers favoured trained volunteers as DOT supporters. ...

Research paper thumbnail of Roles and competencies of district pharmacists: a case study from Cape Town

Prof John Seager, for their guidance and support throughout this lengthy journey and I thank also... more Prof John Seager, for their guidance and support throughout this lengthy journey and I thank also my colleagues, family and friends who have encouraged me through the many highs and lows. In addition, I am grateful to the University of the Western Cape for providing funding and study leave to conduct the research and produce this thesis report. Finally, I want to thank my two sons, Thomas and James, for their understanding whilst I have been busy with this research and for their technical assistance in finalising the thesis report. v Dedication This thesis is dedicated to the late Drs Ivan Toms and Jamie Claassen of City Health and Metro District Health Services, respectively, whose vision and commitment to district health services was exemplary and who inspired and supported this research.

Research paper thumbnail of Improving the quality of pharmaceutical services

SA Pharmaceutical Journal, 2011

This year, the SAAHIP Conference workshop focused on improving the quality of pharmaceutical serv... more This year, the SAAHIP Conference workshop focused on improving the quality of pharmaceutical services. This should be an aspiration of all SAAHIP pharmacists, and is equally applicable in the varied areas in which SAAHIP members work. This includes pharmacists who work in the public and private sectors, in tertiary and district hospitals, community health centres, and primary care clinics, as well as in management and policy-making settings. Improving the quality of health care is the central purpose of the Department of Health’s initiative to introduce National Core Standards for Health Establishments in South Africa. 1,2 The National Core Standards correspond with the National Department of Health’s strategic plan for 2009/2012, and the 10-Point Plan of 2009-2014, which highlight “improving the quality of health services” and “the establishment of a quality management and accreditation body” respectively. 1

Research paper thumbnail of Antimicrobial Use at Primary Health Care Level in Lusaka-Zambia

The study was both a prospective and retrospective cross-sectional descriptive study. The aim of ... more The study was both a prospective and retrospective cross-sectional descriptive study. The aim of the study was to assess the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia. Using the WHO methodology and standard indicators of rational medicines use, this study analyzed 800 patient encounters, 520 medicines inventory records, and other baseline data, from 20 small, medium and large designated primary healthcare facilities under the Lusaka district community health office, in Zambia. The results of the study demonstrated irrational prescribing and dispensing of medicines at the 20 health centers, and a need for appropriate interventions.

Research paper thumbnail of Beta-blockers for hypertension (Review)

Research paper thumbnail of Innovations to improve access to and use of medicines for chronic conditions

SA Pharmaceutical Journal, 2016

This year the SAAHIP Conference workshop introduced delegates to current challenges and innovatio... more This year the SAAHIP Conference workshop introduced delegates to current challenges and innovations related to improving access to and use of medicines for chronic non-communicable diseases (NCDs) in South Africa. This topic is of relevance to pharmacists working in hospitals and institutions in a variety of settings in both the public and private sectors across South Africa.

Research paper thumbnail of Study participants’ characteristics

Research paper thumbnail of Frontline managers interview guide

Research paper thumbnail of Global access to quality-assured medical products: the Oxford Statement and call to action

The Lancet Global Health, 2019

Research paper thumbnail of Roles

Research paper thumbnail of COREQ 32 checklist

Research paper thumbnail of Frontline managers quotes

Research paper thumbnail of Assessment of the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia

Background The irrational use of medicines, and increasingly antimicrobials, remains a key health... more Background The irrational use of medicines, and increasingly antimicrobials, remains a key health problem in many developing countries including Zambia. Inappropriate, ineffective and inefficient use of medicines is common in health facilities at all levels. There are many factors influencing irrational prescribing and dispensing of antimicrobials including patients, prescribers, dispensers, the supply system (including industry influences), government regulations and medicines information and misinformation. Study aim The aim of the study was to assess the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia. Study design The study was a cross-sectional descriptive study, with prospective and retrospective components. A standardized research methodology, including tools and indicators, adapted from the World Health Organization, was employed. Study population and sampling The study population included all the 30 government primary level health facilities (health centres) in Lusaka District, from which 20 primary health facilities were sampled using a combination of purposive and random sampling. Using the WHO standard indicators of rational drug use, this study assessed 800 patient encounters, 520 medicines inventory records, and other baseline data, from 20 health facilities at three different levels under the Lusaka district community health office, Zambia. Data collection The data collection tools were numbered and labeled. Tool 1: Prescribing Indicator Form was used to collect prescribing data; Tool 2: Patient Care (Pharmacy) Form was used to record dispensing data; Tool 3: Antimicrobial Availability Form for recording data for the availability of the key indicator antimicrobials and their substitutes; Tool 4: Facility Indicator Consolidation Reporting Form was iv used for consolidating the data collected for each health facility under study; and Tool 5: Facility Medicines Use Indicator Consolidation Form was used for the consolidation of the drug use data for the entire study. Third year Pharmacy Technology students were trained for the data collection process. The patients were first observed from outside the prescriber's room and the dispensing area for consultation and dispensing times respectively, and then they were interviewed to collect the prescribing and dispensing data. The tools were pre-tested. Data analysis After data checking and consolidation, quantitative data were categorized into continuous numerical variables. Calculations were done manually and using computerized analysis (Epi Info package) and presented as simple frequency and means. Ethics Ethical clearance for the study was obtained from University of the Western Cape Senate Research Committee. Permission was obtained from the Lusaka Provincial and District health offices, being the authorities that are overseeing the health facilities included in the study. Furthermore, permission was obtained from the health centre in-charges. Consent was obtained from healthcare providers and patients. Key results and discussion The study found that at the primary level facilities there were more Clinical Officers (55%) than Medical Doctors (25%) and Registered Nurses (20%) in charge of prescribing. The main dispensers were Pharmacy Technologists (85%); there were no Pharmacists available in any of the facilities. A third [259 (32.4 %)] of all the 800 patients in the study were children below 12 years of age. Across the clinics, a mean of 2.94 medicines were prescribed per prescription, with an extremely low rate of prescribing drugs by generic name (36.7%). The proportion of prescriptions including an antibiotic was 36.2 % and 3.4 % included an injectable drug. Linking the antimicrobials and injections to patient diagnoses indicated that many were probably irrational, prescribing decisions. Amoxicillin and metronidazole were by far the most commonly prescribed antimicrobials at 32.0 % and 17.2 % of total antimicrobials, respectively. The essential drugs list was available in 80.0% of facilities and a high percentage of medicines were prescribed from the essential medicines list (81.2%). The overall v mean percentage of medicines packages correctly labeled was considerably low at 44.8 %. The average consultation time was short at 4.0 (range 1-8.4) minutes, whereas the dispensing times were equally short and averaged at 116.6 (range 15-360) seconds, with the range of 15 to 360 seconds. The average percentage of first line antimicrobials available at health facilities was 79 %; and the average percentage of second line, substitute, antimicrobials available was 15 %. Conclusion In line with studies from other settings, this medicines use study found considerable overuse and irrational use of antimicrobials in the primary health care clinics in Lusaka District. Irrational medicine prescribing was common and poor dispensing practices were also seen, resulting in poor use of and adherence to medicines and, consequently, poor therapeutic outcomes. Recommendations Several recommendations have been formulated. They include: Reinforcing the Drug Therapeutic Committees (DTCs) at the national and the local facility level to help manage medicines use; clarification of prescribers and dispensers roles and responsibilities; development, enforcement or adaption of standard operating procedures (SOPS) for prescribing and dispensing; and improvement of prescribing and dispensing practices through introduction of appropriate education, supervision and audit. vi DECLARATION I hereby declare that this study "ASSESSMENT OF THE RATIONAL USE AND AVAILABILITY OF ANTIMICROBIALS AT PRIMARY LEVEL HEALTH FACILITIES UNDER THE LUSAKA DISTRICT COMMUNITY HEALTH OFFICE, ZAMBIA" is my own work and it has not been submitted for any degree or examination to any other university, and that all sources I have used or quoted have been indicated and acknowledged by referencing.

Research paper thumbnail of Key informants quotes

Research paper thumbnail of Study theories and procedures

Research paper thumbnail of Key informants interview guide

Research paper thumbnail of Betabloqueantes para la hipertensión

Research paper thumbnail of How strong is the evidence for use of beta-blockers as first-line therapy for hypertension? Systematic review and meta-analysis

Journal of Hypertension, 2006

Objective To quantify the effect of first-line antihypertensive treatment with beta-blockers on m... more Objective To quantify the effect of first-line antihypertensive treatment with beta-blockers on mortality, morbidity and withdrawal rates, compared with the other main classes of antihypertensive agents. Methods We identified eligible trials by searching the Cochrane Controlled Trials Register, Medline, Embase, reference lists of previous reviews, and contacting researchers. We extracted data independently in duplicate and conducted meta-analysis by analysing trial participants in groups to which they were randomized, regardless of subsequent treatment actually received. Results Thirteen trials with 91 561 participants, meeting inclusion criteria, compared beta-blockers to placebo (four trials; n U 23 613), diuretics (five trials; n U 18 241), calcium-channel blockers (CCBs) (four trials; n U 44 825), and renin-angiotensin system (RAS) inhibitors, namely angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (three trials; n U 10 828). Compared to placebo, beta-blockers reduced the risk of stroke (relative risk 0.80; 95% confidence interval 0.66-0.96) with a marginal fall in total cardiovascular events (0.88, 0.79-0.97), but did not affect all-cause mortality (0.99, 0.88-1.11), coronary heart disease (0.93, 0.81-1.07) or cardiovascular mortality (0.93, 0.80-1.09). The effect on stroke was less than that of CCBs (1.24, 1.11-1.40) and RAS inhibitors (1.30, 1.11-1.53), and that on total cardiovascular events less than that of CCBs (1.18, 1.08-1.29). In addition, patients on beta-blockers were more likely to discontinue treatment than those on diuretics (1.80; 1.33-2.42) or RAS inhibitors (1.41; 1.29-1.54). Conclusion Beta-blockers are inferior to CCBs and to RAS inhibitors for reducing several important hard end points. Compared with diuretics, they had similar outcomes, but were less well tolerated. Hence beta-blockers are generally suboptimal first-line antihypertensive drugs.

Research paper thumbnail of A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

The International Journal of Tuberculosis and Lung Disease, 2020

INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwid... more INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: T...

Research paper thumbnail of A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

The International Journal of Tuberculosis and Lung Disease, 2020

INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwid... more INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: T...

Research paper thumbnail of Treatment Short-course (DOTS) in Mopani District of Limpopo

The purpose of the study was to assess factors contributing to poor performance of Directly Obser... more The purpose of the study was to assess factors contributing to poor performance of Directly Observed Treatment Short-Course (DOTS) in Mopani district of Limpopo Province, South Africa. An exploratory qualitative approach was used to investigate the factors that contribute to poor performance of the DOTS Strategy. Four focus group discussions were conducted, two with Directly Observed Therapy (DOT) Supporters and two with patients on treatment for more than 6 months. The focus groups (4) discussions were tape-recorded. Data collected were descriptively analyzed using thematic methods. The patients generally found supervision of TB treatment helpful as they were motivated and encouraged to continue treatment. Some of the aspects identified as being unhelpful were the inconvenient times for treatment support and stigma due TB supporters ’ visit to patients home. Patients often preferred family members as supporters, whereas health workers favoured trained volunteers as DOT supporters. ...

Research paper thumbnail of Roles and competencies of district pharmacists: a case study from Cape Town

Prof John Seager, for their guidance and support throughout this lengthy journey and I thank also... more Prof John Seager, for their guidance and support throughout this lengthy journey and I thank also my colleagues, family and friends who have encouraged me through the many highs and lows. In addition, I am grateful to the University of the Western Cape for providing funding and study leave to conduct the research and produce this thesis report. Finally, I want to thank my two sons, Thomas and James, for their understanding whilst I have been busy with this research and for their technical assistance in finalising the thesis report. v Dedication This thesis is dedicated to the late Drs Ivan Toms and Jamie Claassen of City Health and Metro District Health Services, respectively, whose vision and commitment to district health services was exemplary and who inspired and supported this research.

Research paper thumbnail of Improving the quality of pharmaceutical services

SA Pharmaceutical Journal, 2011

This year, the SAAHIP Conference workshop focused on improving the quality of pharmaceutical serv... more This year, the SAAHIP Conference workshop focused on improving the quality of pharmaceutical services. This should be an aspiration of all SAAHIP pharmacists, and is equally applicable in the varied areas in which SAAHIP members work. This includes pharmacists who work in the public and private sectors, in tertiary and district hospitals, community health centres, and primary care clinics, as well as in management and policy-making settings. Improving the quality of health care is the central purpose of the Department of Health’s initiative to introduce National Core Standards for Health Establishments in South Africa. 1,2 The National Core Standards correspond with the National Department of Health’s strategic plan for 2009/2012, and the 10-Point Plan of 2009-2014, which highlight “improving the quality of health services” and “the establishment of a quality management and accreditation body” respectively. 1

Research paper thumbnail of Antimicrobial Use at Primary Health Care Level in Lusaka-Zambia

The study was both a prospective and retrospective cross-sectional descriptive study. The aim of ... more The study was both a prospective and retrospective cross-sectional descriptive study. The aim of the study was to assess the rational use and availability of antimicrobials at primary level health facilities under the Lusaka district community health office, Zambia. Using the WHO methodology and standard indicators of rational medicines use, this study analyzed 800 patient encounters, 520 medicines inventory records, and other baseline data, from 20 small, medium and large designated primary healthcare facilities under the Lusaka district community health office, in Zambia. The results of the study demonstrated irrational prescribing and dispensing of medicines at the 20 health centers, and a need for appropriate interventions.

Research paper thumbnail of Beta-blockers for hypertension (Review)

Research paper thumbnail of Innovations to improve access to and use of medicines for chronic conditions

SA Pharmaceutical Journal, 2016

This year the SAAHIP Conference workshop introduced delegates to current challenges and innovatio... more This year the SAAHIP Conference workshop introduced delegates to current challenges and innovations related to improving access to and use of medicines for chronic non-communicable diseases (NCDs) in South Africa. This topic is of relevance to pharmacists working in hospitals and institutions in a variety of settings in both the public and private sectors across South Africa.