SA doctors’ get behind medicine compliance initiative
Improving HIV treatment adherence for better outcomes
Thursday, 16 January 2019, Non-adherence to prescribed antiretroviral medicine or break in treatment can result in drug-resistance and should therefore be avoided at all costs. While not every missed dose will necessarily result in HIV drug resistance, which limits the scope of medicines that are likely to be effective for an individual living with HIV, the general principle of adhering to prescribed treatment should be followed at all times for best results.
“Every missed dose of antiretroviral [ARV] medicine can potentially lead todrug resistance, although this is more likely with certain groups of ARVs than others. As pharmacists, we therefore advise that it is never safe to miss a dose of chronic medicine for HIV,” says Majanie Krüger, Medipost Pharmacy fund manager to one of South Africa’s largest medical schemes.
“The introduction of antiretroviral therapy has substantially improved the survival of people living with HIV and Aids. The key factor in the effectiveness of such medicines is continuous supply and strict, ongoing adherence to the prescribed treatment. This means taking medicines exactly as prescribed.”
Chronic medicine patients, in particular, require support and ongoing reliable access to prescribed chronic medicines to get the best results. Even in more developed nations, the World Health Organization (WHO) estimates that only approximately half of people who are prescribed chronic medication adhere to their treatments1.
The Medipost group is dedicated to providing convenient access to medicine through its courier pharmacy division, Medipost Pharmacy, and pharmaceutical distribution arm, MediLogistics. MediLogistics provides a service whereby parcels of prescribed chronic medicine are delivered to pick up points, including doctors’ practices, where the patient can collect them, while Medipost Pharmacy delivers medicine parcels directly to any address within South Africa.
General practitioner Dr Mfanelo Titus, who practises in Sterkspruit in the Joe Gqabi District Municipality, was one of the first wave of doctors to register with MediLogistics to have his practice registered as a chronic medicine collections point for his patients.
According to Dr Titus, patients find the service highly convenient and this goes a long way towards making it easier for them to adhere to their prescribed treatment.
“This service has been greatly beneficial in that it improves overall management of my chronic patients, including those who are living with HIV. The reliable supply of chronic medicine is very reassuring for patients, and for their doctors, as a break in the treatment regime can have negative consequences for the patient’s wellness.
“An additional benefit of the service is that my patients can phone Medipost Pharmacy’s pharmacists and pharmacist’s assistants if they have any questions about their medicine and how it must be taken for maximum effectiveness.
“Since our practice became a medicine collection point for patients, I have noticed that those making use of the service are seeing the benefits of improved adherence and this has been very positive in terms of improved wellness,” Dr Titus notes.
Dr Mavabaza Mbombi, a general practitioner in Giyani, Limpopo, says that he values the fact that his patients are guaranteed of reliable delivery of chronic medicines through the MediLogistics service, and the fact that their medical confidentiality is protected.
“As my practice is open 24 hours a day, seven days a week, my patients are able to collect their medicine in their own time. They do not need to make arrangements to collect their medicine during normal working hours, as they have the option to come and fetch their parcels of medicine after hours, over the weekend or even on public holidays.”
Dr Phineas Dombo, who also practises in Giyani, agrees that MediLogistics has made it simpler than ever before for patients to access their medicine. “My patients are very satisfied that they can simply collect their chronic medicine from the same place they are used to visiting for their medical check ups. This has made it easier for them to adhere to their prescribed medicine, and this in turn leads to excellent clinical outcomes,” Dr Mbomi says.
The simplicity of the system is appreciated by the doctors, as Medipost Pharmacy engages directly with patients to remind them to collect their new parcels of chronic medicine and reminds both patient and doctor when the prescription needs to be renewed.
“Medipost continues to interact with the patient through continuous contact with patients to ensure they know when their medicine parcels are ready for collection at the doctors’ practices. If a parcel is not collected by the patient by a certain date, Medipost will remind the patient to collect the patient-ready parcel,” adds Krüger.
“For the convenience of accessing your chronic medicines timeously, Medipostwill facilitate the authorisation from the patient’s medical scheme for their chronic medicines, if the individual is a medical scheme member, so that this is one less thing for them to worry about.”
At this time of year, many people go away on holiday, however Medipost makes provision for this according to the patient’s needs. “By prior arrangement, Medipost can arrange for a parcel to be delivered to a medicine collection point near their holiday destination if it is within South Africa or an actual physical address. This means there should be no interruption to treatment, which is essential for the proper management of chronic conditions, including HIV, diabetes, asthma and many others.”
Throughout this whole process, confidentiality is safeguarded because all parcels are wrapped and sealed before they are despatched to the medicine collection points. “It is not possible for anyone who sees the parcel to know what kind of medication it contains. All parcels have a unique identifying code to ensure that the correct parcel is dispensed to the correct patient, and the reminder service helps to ensure these parcels are collected at the right time to ensure there is no break in treatment,” she notes.
The system MediLogistics and registered doctors’ practices use for monitoring the medicine collections, scans each parcel code when it is delivered to the doctor’s rooms and is scanned again when the patient comes to collect their medicine. This provides an additional record of the patient journey and their compliance with the prescribed medicine.
“It is a win-win situation for patients and their doctors because of the convenience of being able to collect their medicine directly from their doctor’s practice, which makes medicine more accessible.
“For doctors, the relationship with patients is strengthened as doctors are able to check whether their patients have collected the medicine they need. Doctors also note that with improved compliance, their patients with chronic health conditions in general tend to get the best out of the available treatment.
“This MediLogistics service is growing in popularity, because it drives compliance and hence improved wellness,” Krüger concludes.
Reference and further reading:
- World Health Organization (2003). Adherence to long-term therapies: evidence for action http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf?ua=1
Issued by: Martina Nicholson Associates (MNA) on behalf of Medipost Pharmacy and MediLogistics
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016