Stavros Nicolaou

South African patients are essentially getting a raw deal when it comes to medication counselling and assured adherence

“In the United States they experience from 25% to up to 50% non-adherence to prescribed medication, while $100bn is spent on avoidable hospitalisations. We don’t have data on this for South Africa but no reason believe we don’t have the same problem here. We do, if not worse!” Aspen Pharma executive, Stavros Nicoloau, told his audience at this week’s Africa Health Management Conference in Midrand.

Non-compliance, he stressed, was still a major issue largely due to patients not understanding instructions, forgetting, feeling better, or being put off by the medication costs or co-pays: “Many have co-morbidities which confuse them, they become indecisive and put off taking the medication.

“But are they getting the right instructions from their pharmacist, for example, when taking delivery of their medication?” Nicoloau asked. “In many instances pharmacists spend too much time on the phone to the patient’s medical scheme finding out if the scheme is going to pay rather than spending the time counselling the patients.”

Critical in this regard, he added, was the collaboration between doctors and the pharmacists, electronic collaboration now possible through IT connectivity: “These and similar measures must be taken if we are going to cut out the risks of iatrogenesis being experienced.”

Alluding to the well-known issues facing public sector patients, the “long queues of sick people outside our hospital dispensaries awaiting their medications” – and the many who do not actually get their medication in this country – Nicoloau blamed the system, not the policy, and was something that should have been addressed long ago.

Part of the problem in the public sector was a patient seeing a different doctor every time, an unacceptable situation that could be attributed largely to a medical records shortcomings. Said Nicolaou “In Israel, for example, they have a national medical records system and this for one would, no doubt, provide the answer to the problem of seeing a different doctor every time and no least the resulting medication adherence problems.”