Medicine deliveries the future after Covid-19 proves their worth: UCT researchers

When Covid-19 hit SA and stigmatisation was at its peak, many healthcare workers were shunned in their communities due to fear of the virus.

So when two Cape Town clinics started doing home visits to patients with non-communicable diseases (NCDs) — those most at risk of Covid-19 complications — some  were reluctant to take part.

But thanks to healthcare workers’ perseverance, the crisis-management strategies they introduced to accommodate these patients has paid off.

According to a new study by the University of Cape Town (UCT), managing stable NCD patients at home rather than at clinics, is the future and should be retained even after pandemic.

The study assessed the impact of the first Covid-19 wave on the management and care of patients with conditions such as high blood pressure, high cholesterol, heart disease and diabetes. 

Clinics were disrupted and overwhelmed during the first wave by Covid-19 patients, staff shortages and low morale due to infections among staff.

In response, they organised new systems for home delivery of medication and found that this not only reduced the workload but allowed staff to work more efficiently.  

Community healthcare workers visited stable NCD patients and fed information back to  professional nurses, while unstable patients continued to be seen at the clinic.

The study revealed “improved communication between facility and community-based health workers, and the co-ordination of home delivery of medication”.  

In the first month of lockdown, community healthcare workers from the two clinics delivered 184,000 medication parcels to households. They also conducted community screening and testing in vulnerable communities as well as Covid-19 related health education and risk communication.

“Staff members, and especially those with comorbidities, were afraid when another staff member tested positive. Those who showed symptoms of Covid-19 and were tested positive spread fear of infection among their colleagues,” noted lead researcher Dr Peter Delobelle and colleagues whose paper has been published in the African Journal of Primary Health Care and Family Medicine.

The researchers said healthcare workers also faced threats when delivering medication, and in some instances were stoned by people who viewed them as carriers of Covid-19.

“Some patients were particularly apprehensive in the beginning of lockdown because of the fear of the virus being passed on to them,” researchers noted.

A community healthcare worker who took part in the study said: “For me it was a bit stressful because of going out to the clients. You have to go back to your house, you can get the virus, you can take it back home. But in the end I just did what I had to do and provide support for the family.”

Another  said: “I did it out of love. I have a love for my work, for the community. I care. I’m going to try to help where I can.”

Researchers said people sometimes locked their doors for fear of infection, “but also started to appreciate the home delivery of medication, as they were able to save money, avoid risk of infection and avoid the inconvenience of standing in long queues to collect medication”.

Delobelle and colleagues said their findings “offer some indication as to how NCD health policy could be informed post-Covid-19 by retaining the home delivery of medication. Home delivery of medication was highly appreciated, (but) more research studies are needed to measure the actual impact of Covid-19 on NCDs care and management.”