Public health’s relief with chronic meds

MORE CONVENIENT PICK-UPS FOR PATIENTS Waiting in long queues and the admin involved makes it likely patients will default on treatment.

It’s well-known that patients in public health facilities often wait in long queues for medicines that may not be available, while over-stretched health workers try to juggle competing demands. The past decade has seen a sharp rise in the number of patients needing chronic medication for a range of conditions. While SA provides universal access to antiretroviral therapy for patients living with HIV and Aids, the country’s also facing an uptick in non-communicable diseases, such as diabetes and hypertension.

This unexpected shift has put public health workers and facilities under great pressure and has led to medicine shortages and concerns about quality of professional care. Patients often spend money they can ill-afford on transport to health facilities and even lose a day’s wages due to absence from work. This makes it more likely that patients will default on their treatment.

An innovative programme by the department of health, supported by HST, aims to change this. The CCMDD programme improves access to chronic mediation for patients in a stable condition, by allowing them to collect repeat medication from a convenient pick-up point near home or work, including from some big retail outlets such as Clicks and Dischem. Patients can also collect their medicines after hours and on weekends.

The programme uses a centralised dispensing operation that obtains prescriptions for stable chronic patients from health facilities and dispenses a package of medicines for each patient, which they can collect from a health facility (using an express queue) or another convenient pickup point. Patients are also able to nominate two persons, such as a family member, to collect their repeat medicine parcels.

By September 2016, more than 735 080 patients in 37 Districts and 1 672 health facilities were participating in this scheme.

Feedback from healthcare workers shows this programme reduced their workload, giving them time for longer consultations with patients.

Batha Msweli, 33, is a practice manager for a private GP’s surgery in a township. “If patients go the polyclinic they have to be there as early as 5am to get in the queue. Now they don’t wait more than five minutes.”

The Kwa-Mashu polyclinic now refers patients to this private pick-up point.

“The meds are pre-packaged, so when I am handing over the packages the patients know that the contents are confidential. We also set follow-up dates and remind them when it’s time for a review.”

HST is the primary support partner for CCMDD and provides technical support in seven districts regarding CCMDD policy implementation. Provincial support is provided in seven provinces (excluding Western Cape and Northern Cape).