Alternative mechanisms for delivery of medication in South Africa: A scoping review

Background: The number of people in South Africa with chronic conditions is a challenge to the health system. In response to the coronavirus infection, health services in Cape Town introduced home delivery of medication by community health workers. In planning for the future, they requested a scopin...

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Main Authors: Robert Mash, Carmen Christian, Ruvimbo V. Chigwanda
Format: Article
Language:English
Published: AOSIS 2021-08-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/5274
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author Robert Mash
Carmen Christian
Ruvimbo V. Chigwanda
author_facet Robert Mash
Carmen Christian
Ruvimbo V. Chigwanda
author_sort Robert Mash
collection DOAJ
description Background: The number of people in South Africa with chronic conditions is a challenge to the health system. In response to the coronavirus infection, health services in Cape Town introduced home delivery of medication by community health workers. In planning for the future, they requested a scoping review of alternative mechanisms for delivery of medication to patients in primary health care in South Africa. Methods: Databases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Data was analysed both quantitatively and qualitatively. Results: A total of 4253 publications were identified and 26 included. Most publications were from the last 5 years (n = 21), research (n = 24), Western Cape (n = 15) and focused on adherence clubs (n = 17), alternative pick-up-points (n = 14), home delivery (n = 5) and HIV (n = 17). The majority of alternative mechanisms were supported by a centralised dispensing and packaging system. New technology such as smart lockers and automated pharmacy dispensing units have been piloted. Patients benefited from these alternatives and had improved adherence. Available evidence suggests alternative mechanisms were cheaper and more beneficial than attending the facility to collect medication. Conclusion: A mix of options tailored to the local context and patient choice that can be adequately managed by the system would be ideal. More economic evaluations are required of the alternatives, particularly before going to scale and for newer technology.
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institution Kabale University
issn 2078-6190
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language English
publishDate 2021-08-01
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series South African Family Practice
spelling doaj-art-b9a6ae9c82914bc3b7c8f01ee5e893062025-08-20T03:47:09ZengAOSISSouth African Family Practice2078-61902078-62042021-08-01631e1e810.4102/safp.v63i1.52744152Alternative mechanisms for delivery of medication in South Africa: A scoping reviewRobert Mash0Carmen Christian1Ruvimbo V. Chigwanda2Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownDepartment of Economics, Faculty of Economics and Management Sciences, University of the Western Cape, BellvilleDivision of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape TownBackground: The number of people in South Africa with chronic conditions is a challenge to the health system. In response to the coronavirus infection, health services in Cape Town introduced home delivery of medication by community health workers. In planning for the future, they requested a scoping review of alternative mechanisms for delivery of medication to patients in primary health care in South Africa. Methods: Databases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Data was analysed both quantitatively and qualitatively. Results: A total of 4253 publications were identified and 26 included. Most publications were from the last 5 years (n = 21), research (n = 24), Western Cape (n = 15) and focused on adherence clubs (n = 17), alternative pick-up-points (n = 14), home delivery (n = 5) and HIV (n = 17). The majority of alternative mechanisms were supported by a centralised dispensing and packaging system. New technology such as smart lockers and automated pharmacy dispensing units have been piloted. Patients benefited from these alternatives and had improved adherence. Available evidence suggests alternative mechanisms were cheaper and more beneficial than attending the facility to collect medication. Conclusion: A mix of options tailored to the local context and patient choice that can be adequately managed by the system would be ideal. More economic evaluations are required of the alternatives, particularly before going to scale and for newer technology.https://safpj.co.za/index.php/safpj/article/view/5274primary health careprimary caremedication systemsadherence clubs, home deliveryalternative pick-up-points
spellingShingle Robert Mash
Carmen Christian
Ruvimbo V. Chigwanda
Alternative mechanisms for delivery of medication in South Africa: A scoping review
South African Family Practice
primary health care
primary care
medication systems
adherence clubs, home delivery
alternative pick-up-points
title Alternative mechanisms for delivery of medication in South Africa: A scoping review
title_full Alternative mechanisms for delivery of medication in South Africa: A scoping review
title_fullStr Alternative mechanisms for delivery of medication in South Africa: A scoping review
title_full_unstemmed Alternative mechanisms for delivery of medication in South Africa: A scoping review
title_short Alternative mechanisms for delivery of medication in South Africa: A scoping review
title_sort alternative mechanisms for delivery of medication in south africa a scoping review
topic primary health care
primary care
medication systems
adherence clubs, home delivery
alternative pick-up-points
url https://safpj.co.za/index.php/safpj/article/view/5274
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AT carmenchristian alternativemechanismsfordeliveryofmedicationinsouthafricaascopingreview
AT ruvimbovchigwanda alternativemechanismsfordeliveryofmedicationinsouthafricaascopingreview