Analysis of the impact of pharmacist initiated management of antiretroviral therapy (PIMART) on health services inputs, processes and outcomes in South Africa

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Keywords:

pharmacist initiated management of antiretroviral therapy, health services

Abstract

The analysis investigates the impact of the pharmacist initiated management of antiretroviral therapy (PIMART) programme on South Africa's healthcare system. Amid challenges in meeting UNAIDS 2030 targets, particularly in antiretroviral treatment (ART) accessibility, the PIMART initiative seeks to address these issues by leveraging community pharmacists. The study adopts the Donabedian model, assessing inputs, processes, and outcomes on the quality of the programme.

Inputs highlight the potential benefits of task-sharing to pharmacists, including extended operating hours, shorter waiting times, and increased accessibility. The regulatory framework ensures pharmacist readiness through training, which aligns with the national policy of competency-based prescribing.

Processes involve a legal dispute between PIMART and private doctors, emphasising the need for collaboration and stakeholder engagement. As community pharmacists transition to patient-centred care, they offer early intervention and improved adherence through existing mechanisms. Financial implications underscore cost savings to patients, though a robust referral system is crucial for those unable to afford treatment.

Outcomes focus on the programme’s ability to improve accessibility, reduce disease burden, and address medical professional shortages. Outcome measures include changes in infection rates, treatment rates, viral suppression, and mortality reduction. Quality of care is assessed through safety, efficiency, and community acceptability.

The analysis highlights the potential for PIMART to enhance human immunodeficiency virus (HIV) care, urging a careful balance between accessibility, patient safety, and continuous monitoring to ensure programme sustainability. Leveraging community pharmacists’ expertise emerges as a strategic move to achieve UNAIDS targets and improve overall public health in South Africa.

Author Biography

NM Amod, London School of Hygiene and Tropical Medicine

London School of Hygiene and Tropical Medicine, United Kingdom

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Published

2024-08-22

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Section

Original Research