A concerning number of healthcare workers (HCWs) in South Africa lack sufficient understanding of how the antiretroviral (ARV) drug Dolutegravir (DTG) interacts with medicines prescribed to treat tuberculosis (TB), diabetes and epilepsy, a study has found.<\/p>\n\n\n\n
This knowledge gap could result in large- scale, dire ramifications for people living with HIV. <\/p>\n\n\n\n
University of Cape Town (UCT) PhD student Briony Chisholm highlighted these findings in her master\u2019s research paper titled \u201cSouth African healthcare workers\u2019 knowledge on Dolutegravir\u2019s drug-drug interactions in the first year of its roll-out: a cross-sectional online survey\u201d. <\/p>\n\n\n\n
She co-authored the paper with her colleagues Prof Marc Blockman, the director of UCT\u2019s Medicines Information Centre (MIC), and Annoesjka Swart, the manager of the MIC.<\/p>\n\n\n\n
The aim for the project was to gauge how well HCWs understood DTG\u2019s interactions with other critical medications prescribed to treat a range of health challenges. DTG is a relatively new ARV, introduced as the preferred first-line HIV therapy in South Africa in 2019. <\/p>\n\n\n\n
\u201cJust one HCW working in a clinic without knowledge of DTG\u2019s interactions with other medications is one too many,\u201d she said.<\/p>\n\n\n\n With a clear research objective, Chisholm set off on her fact-finding mission. Establishing the level of training HCWs received on DTG and its interactions with other key medicines used to treat TB (Rifampicin) and diabetes (Metformin), as well as some anti-epileptic medications was step one. Determining whether they understood that some medicines required an adjusted dosage if prescribed in tandem with DTG was step two.<\/p>\n\n\n\n Her initial project involved travelling around the country to obtain answers to her questions. After all, getting a first-hand account was always first prize. And for this avid road tripper who loves back roads and interacting with people, it was exciting too. <\/p>\n\n\n\n But the Covid-19 pandemic threw a large spanner in the works and Chisholm was forced to change gear. As a result of lockdown, she converted her research study into an anonymous online survey and targeted HCWs across South Africa. <\/p>\n\n\n\n \u201cIn hindsight, this was a far better project. It gave us good insight into where the gaps were,\u201d she said.<\/p>\n\n\n\n Chisholm received an overwhelming response to her survey. A total of 1 950 HCWs participated, 41,1% were nurses, 35,8% were doctors and 8,9% were pharmacists. Roughly 70% of respondents indicated that they understood that DTG interacts with other medications, 13,9% said they did not, and 16,1 chose not to answer the question.<\/p>\n\n\n\n \u201cWhen we looked closer at whether HCWs knew how to adjust medicine dosages due to its interactions with DTG, the gaps widened further,\u201d she said. \u201cMedicine adjustments are crucial in this context. If HCWs don\u2019t fully understand these adjustments, it could result in HIV-1 resistance, which means treatment may fail and increased HIV transmission may occur.\u201d<\/p>\n\n\n\n Chisholm said she couldn\u2019t just leave it there. She needed to find a solution to the problem and improve the knowledge gaps for all HCWs in the country, and the outcome for people living with HIV.<\/p>\n\n\n\n \u201cI hate leaving things half done. My first question to myself after I concluded the survey was how do we fill the gaps and how do we support HCWs to access the resources they need to understand everything better, especially those in more remote areas,\u201d she said.<\/p>\n\n\n\n Almost immediately skills training came to mind, and the idea to develop a training programme seemed like a good idea. But the training Chisholm has in mind is quite unconventional and more geared towards the modern technology-driven world. It doesn\u2019t require a massive amount of time in a classroom setting or long reads through training manuals. Instead, HCWs receive succinct, sharp and punchy course material delivered straight to their mobile phones via WhatsApp, and when necessary, they are directed to the National HIV and TB Hotline for specific clinical assistance. <\/p>\n\n\n\n \u201cDoctors, nurses and pharmacists don\u2019t have the time to spend two or three days in training. They need to be in the clinic treating patients. Also, distances to central training centres are often large and the financial resources are scarce. But with this WhatsApp training programme, they can receive the information they need easily on their phones. They can learn something valuable while taking care of patients,\u201d she said. \u201cIt\u2019s also less taxing on the individual\u2019s concentration span to receive bite-sized chunks of learning.\u201d<\/p>\n\n\n\n .<\/span> Story by Ni\u00e9mah Davids, UCT News<\/span>.<\/p>\n","protected":false},"excerpt":{"rendered":" A concerning number of healthcare workers (HCWs) in South Africa lack sufficient understanding of how the antiretroviral (ARV) drug Dolutegravir (DTG) interacts with medicines prescribed to treat tuberculosis (TB), diabetes and epilepsy, a study 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