Medical Schemes’ Disease Management Programmes (DMPs) and Designated Service Providers (DSPs) produced satisfactory results for medication delivery and adherence to HIV treatment, a study supervised by UKZN’s Public Health Specialist/Lecturer, Dr Ozayr Mahomed, revealed.
Titled: “Patient Experiences with Designated Service Provider Medication Delivery in a Rural General Practice in KwaZulu-Natal: a Cross-Sectional Study on HIV Patients”, the research aimed to assess the process of DSP pharmacy medication delivery, patient satisfaction and adherence to HIV treatment, whilst receiving medication through a DSP at a family practice.
The study was conducted by Dr Vinor Reddy a General Practitioner in Tongaat as part of his research for his Masters of Medical Science degree.
The study was conducted between January and June 2013 within the designated family practice amongst all HIV patients who were receiving antiretroviral treatment provided by healthcare funders via DSP agreements (Medipost and Direct Medicines). Data were collected using an anonymous self-administered questionnaire as well as a record review tool.
The research found that 77% of patients received their antiretroviral medication deliveries on time, 88% received a reminder before delivery and 77% received correct medications.
It also found that short messaging services (SMS) were the most popular method used to inform patients of an impending medicine delivery with 85% of all respondents reporting they received SMS messages. Some 70% of the patients rated their satisfaction with DSP medication delivery between good and excellent while the remainder rated the service as satisfactory to poor.
‘In 2006, there were over 17 DMPs providing antiretrovirals to patients with five major players - Aids for Aids (36%), Lifesense (15%), Discovery (11%), Arum Health (11%), and Qualsa (11%) - accounting for the majority of the patients,’ Mohamed said.
The programme consisted of two components - Health Education and Promotion and Therapeutic - which addressed the cost effective treatment of the patients using relevant guidelines and the delivery of patient medication using DSPs.
According to Mohamed, DSP pharmacy services are increasingly being used by medical schemes to provide ART to patients. ‘Successful HIV management is dependent on near perfect adherence to ART, which is in turn dependant on a reliable supply of antiretroviral medications. With this in mind, the DSPs have employed medical advisors for making treatment recommendations and authorising of appropriate treatment.’
He said case managers provide support and counselling for the individuals in their care and ensure that the patient prescription is forwarded to the drug distributor. ‘In addition, the case manager ensures that the patient receives the monthly supply of medication and establishes monthly contact to counsel the patient and monitor the correct use of the dispensed drugs.’
‘Our study found general satisfaction with the DSP delivery of ART medication. This may be in part due to the higher level of education among participants in the survey. However, it is important that DSP is not considered as a substitute for consulting the doctor and any inefficiency within the system is eliminated as not to compromise the treatment of the patient.’
Mohammed said although the study had been done in the private sector, it had important considerations for the public sector with the implementation of the National Health Insurance and the Chronic Care Medication Dispensing Programme.