The involvement of community pharmacists in the syndromic approach to the management of sexually transmitted infections : a proposed best practice model

[摘要] ENGLISH ABSTRACT: 'Between 6.29 million and 6.57 million people in South Africa are estimated to be HIV positive (Quinn, 7/11/2005) The primary issue pertaining to HIV/AIDS, is the control of the spread of the infection. A critical intervention strategy entails the effective management of sexually transmitted infections, which could reduce the HIV incidence by 40% according to Mayhew,S. et. al, 2001.Factors such as; stigma, limited resources, inaccessibility to affordable and effective drugs etc, impact on the management of STIs. In view of the significant consequences of inadequate STI management, there is growing international support for STI prevention and control. It is clear that decreasing the rate of STI infection will impact positively on reducing the spread of HIV and AIDS.Numerous epidemiological and biological studies now support the fact that STIs, enhance HIV transmission (Wasserheit JN, 1992). Those infected with HIV become more infective, due to the STI related inflammatory conditions. The more frequent the episodes of STI in a HIV positive individual, the faster the progression to full-blown AIDS.This dissertation therefore, endorses the current strategy by the State involving the syndromic approach in the management of STIs. This approach is a treatment option based on the identification of a constellation of symptoms and signs experienced by the patient. The focus of this paper is a proposal for inclusion of pharmacists as essential role-players in this programme of action. Considering the significant role of the pharmaceutical industry in drug management, it is incomprehensible that the Government's strategic plan currently excludes pharmacists. Pharmacists, generally, are perceived as trusted health care professionals with extensive knowledge on health care issues. Thus training pharmacists in the syndromic approach will certainly contribute to effective control of the infection. Issues such as adherence counselling will have a better prognosis due to the specialized knowledge of the pharmacist; and follow-up, if required, will be easily accessible to the patient. Further, the patient will be able to report any side effects, seek change to treatment and discuss any concerns almost immediately with the pharmacist. The benefit will be seen in the possible decrease in the number of new infections, due both to the professional counselling intervention, and early detection. In view of the aforementioned, this paper proposes a review of legislation as well as the Government's strategic plan for STI management. It goes further to suggest a best practice model for the involvement of pharmacists in the programme of action to reduce the spread of STIs, and subsequently, HIV and AIDS. It projects a vision of a new professional role for pharmacy in the context of public/private partnerships in health delivery programmes. The rigorous tertiary training of pharmacists certainly suggests that their role surpasses the arena of drug delivery management and must therefore not be the only focus of their professional role. They must be seen as an essential part of the health care team with the freedom and endorsement to use the other professional skills with which they're equipped, to provide more comprehensive patient care.

[发布机构] Stellenbosch University