By: Lunga Memela (HST Communications Engagement Lead)
HST's Advanced Clinical Care Clinician, Dr Ganizani Mlawanda
The global community commemorates World Patient Safety Day on Saturday, 17 September 2022. To raise awareness, the World Health Organization reminds us that: "Every person around the world will, at some point in their life, take medications to prevent or treat illness. However, medications sometimes cause serious harm if incorrectly stored, prescribed, dispensed, administered or if monitored insufficiently… It is in this context that 'Medication Safety' has been selected as the theme for World Patient Safety Day 2022, with the slogan 'Medication Without Harm'."
Amongst other health interventions, the Health Systems Trust (HST) supported the Department of Health (DoH) in implementing a convenient service called CCMDD (Central Chronic Medicine Dispensing and Distribution) or 'Get Checked. Go Collect' – now transitioned into the Dablapmeds campaign. It allows eligible individuals on chronic medication to collect government-issued treatment for free at convenient collection points. It is through such endeavours that HST remains committed to promoting the prevention of illnesses, early detection, accurate diagnosis and encouraging those found to be ill to start taking medication timeously and continuing to adhere as prescribed by healthcare professionals.
About Dr Mlawanda
HST's Communications Unit had a brief chat with one of the organisation's Advanced Clinical Care Clinicians, Dr Ganizani Mlawanda – a Family Physician, Clinical Epidemiologist and Advanced HIV Clinician with over 18 years HIV/AIDS/STIs/TB programme design, implementation and management experience at all levels. He is passionate about HAST (HIV, AIDS, Sexually Transmitted Infections, and TB) and NCDs' (non-communicable diseases) medical education.
Contextualising Patient Safety and Medication Without Harm locally
Q: So Doc, what is patient safety, and why is it important to you as a medical doctor?
A: As a doctor, I took an oath to first DO NO HARM. Therefore, patient safety forms the core of all our daily activities as medical doctors. In particular, it aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Q: Patients present with various ailments when they visit health facilities. What are the dangers of not adhering to a specific medication and completing the regimen as prescribed?
A: Medications can only work if they are taken as prescribed, also termed "adherence" in the medical fraternity. Adherence to therapies is a primary determinant of treatment success. Failure to adhere to treatment affects the patient and also the healthcare system. Medication non-adherence in patients leads to substantial worsening of disease, morbidity, mortality, death and increased healthcare costs, for example worsening both the DALYs (years of healthy life lost) and QALYs (years of healthy life lived). Barriers to adherence could be addressed at patient level, provider and health system levels, with interactions among them.
Q: Can medication be harmful to a patient and, if so, in what instances could this be?
A: While medications are meant to alleviate multiple ailments and discomforts, the reality is that there is a possibility of harm arising along the storage, prescribing and dispensing pathways. In addition, there are inherent unwanted/adverse drug effects, some only identified in the post-marketing phase. This harm-potential applies to over-the-counter (OTC), complimentary and prescription medications. To mitigate harm, patient safety practises minimise harm.
Q: Why is it important for medication to be stored in particular ways, and sometimes at specific temperatures?
A: It is important for medicines to be stored at the prescribed temperatures in order to maintain their stability. If medicines are not stored at the prescribed temperature, then it may affect their potency and thus efficacy. For this reason, it is important to ensure that medicines are always stored at the correct temperature.
Q: What implications do disruptions such as the civil unrest and the KZN floods have on Patient and Medicine Safety?
A: Civil unrest and the resent floods in KZN disrupted the continuous supply of medicines to patients in KZN due to e.g blocked and/or damaged roads. This had a negative effect on medicine safety because patients are supposed to have a continuous and uninterrupted supply of medicines, especially patients on chronic life-saving medication. As healthcare professionals, we need to ensure that the supply of medicines is continuous and uninterrupted at all times to ensure adherence and patient safety.
Q: What more could be done to educate and raise awareness about Patient and Medicine Safety?
A: Patients must be counselled thoroughly on how to take their medication and they must know the names of the medication. They also need to be counselled on the storage condition and the route of administration of their medication. Patients must be educated on the potential side effects and be encouraged to report them should they experience them. Always give a patient the opportunity to ask questions after counselling them.
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