|Background: Since 2005 the Chronic Dispensing Unit (CDU) has been part of the Western Cape Government’s strategy to address increasing demand for chronic medication for patients with non-communicable diseases. However, some patients are unable to collect their pre-packed chronic medication parcels from health care facilities on the due date. Recent research reported that some patients utilise collectors or medicine agents to collect their prepacked chronic medication parcels. Currently little is known about this phenomenon of collectors.
Aim and Objectives: This study explored the acceptability of collectors of CDU chronic medication parcels to improve access to medicines for patients with non-communicable diseases at Lotus River Community Day Centre (LRCDC).
Methodology: An exploratory descriptive qualitative study using semi-structured interviews in English and Afrikaans was conducted with six purposively selected collectors, three patients who use collectors and three key informants who have intimate knowledge of the collectors and system at the health facility. Interviews were recorded, transcribed, translated into English (where applicable) and thematically coded to derive themes from the data. Ethical approval was provided by the University of the Western Cape Bio-Medical Research Ethics Committee and informed consent was obtained from all study participants.
Results: Patients reported that their collectors exhibited positive characteristics such as trust, patience and reliability, as well as, a passion for helping the community and organisational skills. All patients acknowledged the benefits of utilising a collector and found them to be highly acceptable. Key informants, however, had some reservations about the characteristics of collectors and their role in medication distribution and were sceptical as to whether collectors were suitably equipped to perform this function. Patients were grateful when their collector had some knowledge about their condition and were able to converse with them regarding their medication. Key informants suggested that with sufficient training and skills development, collectors could potentially improve access to chronic medication parcels and impart basic knowledge about chronic medication adherence to patients.
Conclusion: The collector system that has emerged at LRCDC is highly acceptable to patients, but health facility staff were more measured in their assessments. Health facility staff, however, acknowledged the potential of collectors to improve access to chronic medication parcels for patients with chronic conditions and the benefit of upskilling collectors to perform this function.
Recommendations: As a short-term measure, collectors should be formally accepted at facilities as medicine agents. They should receive basic education about safe medication distribution practices. Patients should screen collectors to ensure that they have the desired positive attributes. Furthermore, future research is necessary to comprehensively understand the current scope of practice of collectors within communities