Pharmacology

The ART guidelines deal with Fixed Dose Combinations medications and introduces fixed dose combination (FDC) ART for patients initiated with ART for the first time; introduce FDC ART for HIV positive pregnant women irrespective of CD4 count during pregnancy and during the breastfeeding period; phased introduction of FDC to patients with other co-morbidities (diabetes, hypertension and respiratory diseases, including TB); phased introduction of FDC to patients who require switching due to drugs toxicity or switching from Stavudine (d4T) based regime and phased introduction of FDC to patients who are stable of ART and VL suppressed.

INTRODUCTION

It is my pleasure to introduce the third edition of the Standard Treatment Guidelines and Essential Medicines List for Hospital Level. This edition marks the culmination of an intense and thorough review process.

The Standard Treatment Guidelines have been aligned with current developments in medicine and scientifi c advances. Clinical evidence was used in the selection of medicines. In addition, prevailing medicine cost, affordability, as well as practice implications were taken into consideration. Furthermore, harmonisation with priority guidelines within the Department of Health has also been attained.

This report provides information by country on the proportion of adult (age 30 years and above) deaths attributable to tobacco by major communicable and non-communicable causes by age and sex. It builds and is consistent with the global estimate provided in WHO’s 2009 report entitled Global health risks: mortality and burden of disease attributable to selected major risks.

The assessment of client satisfaction, forms an important part of the management of a health facility, especially after the adoption of the Batho Pele (People First) and the Patients Right Charter. The main objective in undertaking this research study was to develop an instrument that would assess the satisfaction levels of clients utilising two district hospitals in South Africa. The hospitals were the Gordonia Hospital in Upington, and the East Griqualand and Usher Memorial Hospitals in Kokstad.

This manual focuses on the process of prescribing. It gives you the tools to think for yourself and not blindly follow what other people think and do. It will help you to understand why certain national or departmental standard treatment guidelines have been chosen, and teaches you how to make the best use of such guidelines.

This Kwik-Skwiz deals with the measurement of drug use patterns and prescribing behaviour and also with the structures which can be used to promote rational drug use at district level and how they can use such measurement information (indicator data). Examples from an indicator study completed in the Kalahari district of the Northern Cape are used to illustrate the use of such data.

Lessons for the implementation of the Essential Drugs Programme within districts.Nurses are the frontline health providers for most people in South Africa today. Many nurses feel ill-equipped for their new role as clinical nursing practitioners. At the same time, clinics often experience shortages of medicines. A process of training and support is needed to ensure that medicines are prescribed and dispensed in a rational and cost-efficient manner.

The Rational Drug Use Training Project is a district-oriented programme designed to improve rational drug use among primary health care prescribers in the South African public sector. The programme was designed as a train-the-trainers system, using district staf f as the trainers. Rational drug use is the process of ensuring a patient receives and takes the correct therapy.