RESUMO
Improved chronic diseases management calls for teams with inter-professional collaboration. The study aims to assess pharmacists’ involvement in collaborative practice with physicians and nurses in anti-retroviral therapy units of five hospitals. Institution based cross-sectional survey with a sample size of 43 pharmacists, physicians and nurses, was conducted in May 2012. The response rate was 86.05% and involved 11 pharmacists, 6 physicians and 20 nurses. The role of the pharmacist was focused on dispensing and patient counseling. Consultation was given to other health professionals by 45.45% of the pharmacists but 54.54% of the pharmacists were not satisfied with their role. 72.72% of the pharmacist indicated collaboration on drug toxicities, side effects and on patient status with physicians and nurses; and rated their working communication and relation with physicians (72.72%) and nurses (81.81%) as ‘very good’. 36.36% of the pharmacists believed that there was no equitable decision making on patient cases. 84.62% of the physicians and nurses rated their collaboration with ART pharmacists as ‘good’ and ‘very good’. Overall, pharmacists’ involvement in collaborative practice with nurses and physicians was found to be a little bit engaging with the patient as compared to the traditional role despite the gaps that exist.
RESUMO
Essential drugs (EDs) satisfy the priority health care needs of a population and their availability and affordability at all times is crucial for provision of complete health service. The study aimed to assess availability and affordability of treatment cost for common diseases in Jimma Health Center (JHC). A cross sectional study was conducted using structured data abstraction form for exit interviews and checklists. Only 128 (55.65%) EDs were available. The average price for commonly used drugs per recommended dose for an individual patient in JHC Pharmacy, Ethiopian Red Cross (ERC) Pharmacy and Private Pharmacies were $0.65, $0.62 and $0.94 respectively. Affordability of medications was significantly associated with age, marital status, occupational status, gross monthly income and number of economically dependent family members (p<0.005). 58.07% of the respondents bought drugs from JHC pharmacy, while the rest bought drugs from ERC pharmacy and private retail outlets. In this study 47.83%, 33.54% and 18.63% of the respondents said that the drugs are not affordable, fairly affordable and affordable respectively. Low availability of EDs forced patients to purchase drugs from private pharmacies, go to informal sector or forgo treatment. Considering proportion of total household income spent on health care, costs of treatment seem unaffordable.
RESUMO
ART brings a complex series of choices; when to initiate therapy, what regimen to use, which class of drugs to use, when to change therapy, and which alternative drugs to use. Therefore, this study aims to assess reasons for initial ART regimen change in Nekemt Hospital. A retrospective cross sectional study was done by reviewing patient information sheet recorded from January 1, 2006 to December 31, 2010. Patients who changed their regimen were included in the study to identify the reasons for change and descriptive statistics were generated using SPSS version 16. Out of 142 patients, 57.7% were females and 57.7% were inthe age group 20-34. 61.2% were WHO clinical stage III patients and 69.7% of patients had a CD4 count below 350 cells/mm3. The most common initial regimens were D4T/3TC/NVP (42.2%), D4T/3TC/EFV (27.5%) and AZT/3TC/EFV (12.7%). The main reasons for modification of therapy were toxicity (80.3%), pregnancy (6.3%), new TB (5.6%), stock out (4.9%) and treatment failure (2.8%). The main toxicity observed was lipoatrophy (58.8%) followed by rash (12.3%) and CNS toxicity (11.4%). Toxicity was the main reason for initial regimen modification. D4T based regimens had high incidence of lipoatrophy.