South African Family Practice - Volume 55, Issue 1, 2013
Volume 55, Issue 1, 2013
Drug interactions in primary health care in the George subdistrict, South Africa : a cross-sectional study : original researchSource: South African Family Practice 55, pp 78 –84 (2013)More Less
Objectives : To investigate the prevalence of potential drug-drug interactions in primary healthcare clinics in the George subdistrict, to determine which drugs were involved, and to identify associated risk factors.
Design : A cross-sectional retrospective folder review was performed.
Setting and subjects : Four hundred randomly selected patient files from four primary care clinics in the George subdistrict.
Outcome measures : The prevalence of potential drug-drug interactions in primary care, drugs involved in potential drug-drug interactions and associated risk factors.
Results : The prevalence of scripts containing at least one moderate potential interaction was 42%; severe potential interaction, 5.25%; and contraindicated combinations, 0.5%. The most common drugs involved were enalapril, aspirin, ibuprofen, furosemide and fluoxetine. The most common implicated drugs in potentially severe interactions were warfarin, aspirin, fluoxetine, tramadol and allopurinol. Two contraindicated combinations were found, namely verapamil plus simvastatin, and hyoscine butyl bromide plus oral potassium chloride. Advancing age and polypharmacy were associated with an increased risk of potential drug-drug interactions. Input from the regional hospital specialist departments greatly increased the risk of a patient being given a prescription that contained a potential drug-drug interaction. Eighty one per cent of severe interactions were from this group.
Conclusion : The potential for drug-drug interactions occurring was common in primary healthcare clinics in the George subdistrict. Drug interactions are predictable and preventable. The risk factors identified in this study may assist in the design of interventions that reduce the risk.
Prevalence of chronic pain in patients attending primary healthcare facilities in south-west Tshwane : original researchSource: South African Family Practice 55, pp 85 –89 (2013)More Less
Objectives : Despite the significant biopsychosocial impact of chronic pain on the health and quality of life of an individual, as well as on healthcare utilisation, no published data are available on the prevalence of chronic pain in the South African primary healthcare context. The aim of this study was to investigate the prevalence and intensity of chronic pain in patients attending primary healthcare facilities in south-west Tshwane.
Design and setting : A prospective, cross-sectional study was carried out in four primary healthcare clinics, situated in south-west Tshwane.
Subjects : The study was conducted on 1 066 adult patients, aged 18 years or older, over a nine-week period between October and December 2010.
Outcome measures : The prevalence and intensity of chronic pain was determined.
Results : Chronic pain prevalence was 41%. The confidence interval (CI) was 37.2-45.6. Chronic pain was most frequently experienced as lower back pain [prevalence 30.83% (CI: 19.56-42.09)] and joint pains [prevalence 23.48% (CI: 7.58-39.38)]. Chronic pain was significantly more prevalent with advancing age (p-value = 0.0014), in women than in men (p-value = 0.019), and in widowed and divorced patients, than in married and single patients (p-value = 0.0062). Patients with chronic pain reported their pain intensity over the previous month as maximum pain intensity (mean: 7.69 ± 0.99), minimum pain intensity (mean 2.54 ± 0.89), and average pain intensity (mean 4.57 ± 0.62).
Conclusion : Chronic pain was highly prevalent in patients who attended primary healthcare facilities in south-west Tshwane. The intensity of pain was high in a significant proportion of patients.
Source: South African Family Practice 55, pp 90 –95 (2013)More Less
Objective : There is a lack of research on humour among adolescents in South Africa. This article examines cognitive flexibility and humour. The objective was to investigate the roles of gender and language as possible moderating variables in the relationship between adolescents' cognitive flexibility and sense of humour.
Design : A correlational research design was used in which pupils were asked to complete the Multidimensional Sense of Humor Scale to assess their sense of humour. In order to determine the cognitive flexibility of the sample group, Martin and Rubin's Cognitive Flexibility Scale was applied.
Setting and subjects : The initial sample comprised 1 203 adolescents (Grade 11 and 12 pupils) randomly selected from the Eastern Cape, Gauteng and Mpumalanga. Of these, a final 392 adolescents qualified after eliminating criteria had been applied.
Results : No significant correlations were found between the total group or for the two genders. Significant positive correlations were found between cognitive flexibility and two of the scores for humour (creating and expressing humour), as well as for the total score for Afrikaans-speaking participants. Significant negative correlations were found between cognitive flexibility and all five of the scores for humour for the Nguni language speakers.
Conclusion : This study recommends that culturally sensitive measuring instruments should be developed.
Closing the prevention of mother-to-child transmission gap in Nigeria : an evaluation of service improvement intervention in Nigeria : original researchSource: South African Family Practice 55, pp 96 –102 (2013)More Less
Objectives : The objective was to assess improvement, or lack thereof, in the uptake of prevention of mother-to-child transmission (MTCT) services at selected sites supported sites by the Global HIV/AIDS Initiative Nigeria (GHAIN).
Design : The study used aggregated monthly service statistics to evaluate service improvement efforts that were conducted before and after these were undertaken between July 2007-June 2008.
Settings and subjects : The service improvement efforts took place in 60 public healthcare facilities.
Outcome measures : The study measured changes in the number of pregnant women who attended antenatal clinics for the first time, the number of pregnant women tested for human immunodeficiency virus (HIV), the number of HIV-positive women receiving antiretroviral (ARV) prophylaxis, and the service ratio, an indicator of the relative uptake of ARV prophylaxis. An estimate of MTCT events that were averted through ARV prophylaxis taken by the pregnant women was also calculated.
Results : One hundred and twenty thousand, five hundred and thirty-seven women attended an antenatal clinic (ANC) for the first time. There was an average of 167.4 monthly attendances per facility. ANC attendance increased per facility by 11.1 women monthly post-intervention (p-value < 0.01). The uptake of HIV testing was 87%, with a monthly average increase of 17.8 women tested per facility (p-value < 0.01). ARV prophylaxis uptake rose from 3.3-5.4 women per facility per month (p-value < 0.01). The service ratio per facility improved from 5.3 women receiving ARVs to 6.5 for every 10 women who tested positive for HIV (p-value < 0.01). Applying risk reduction estimates of different ARV regimens, it was estimated that between 88-169 MTCT events were averted pre-intervention, and 143-276 events, post-intervention.
Conclusion : Service improvement intervention improved the utilisation of PMTCT services. It should be a key intervention that is used to close the PMTCT gap in Nigeria.
Author Chris EllisSource: South African Family Practice 55 (2013)More Less
Ethnography is a term that is generically applied to the study of populations into which the researcher has traditionally entered as an interloper, and then gradually been accepted in various ways: "The ethnographer participates overtly or covertly in people's daily lives for an extended period of time, watching what happens, listening to what is said, asking questions, in fact, collecting whatever data is available to throw light on the issues with which he or she is concerned". This sounds very much like what a general practitioner does all day.