Community pharmacists’ perceptions and experiences of medicine shortages in disruptive situations, in Durban, South Africa.

Abstract

Background: Medicine shortages are a challenge in upper, lower and middle-income countries, including South Africa. In recent years, community pharmacists in Durban, South Africa, have experienced disruptions such as the COVID-19 pandemic, flooding, civil unrest and electricity disruptions. Little is known about the impact of these disruptive situations on medicine shortages in community pharmacies. Aim: Exploring the perceptions of community pharmacists and their experiences with medicine shortages during the COVID-19 pandemic and other disruptive situations. Method: A qualitative methodology was employed to explore the topic in-depth. Convenience and snowball sampling were used to recruit 15 community pharmacists in Durban, South Africa. Semi-structured interviews were conducted in person or via an online video conferencing platform. All interviews were audio-recorded and transcribed verbatim. The transcripts were coded deductively on NVivo 14 software, using the Framework Method of thematic analysis. Initial codes and themes were informed by a literature review and final themes were identified on review. Results: A total of fifteen community pharmacists were interviewed. Five major themes were identified from thematic analysis, viz. the perceptions of medicine shortages, the impact of disruptive situations, the consequences of medicine shortages, mitigation strategies; and further suggestions and resources. Perceptions were that shortages were exacerbated by the disruptive situations. Participants perceived a negative financial impact on patients and pharmacies, with out-of-pocket costs affecting the former and loss of income affecting the latter. The mitigation strategies used were contacting stakeholders, medicine substitution and stock management. Conclusion: Community pharmacists felt that medicine shortages required improved communication, collaboration, policies, notification systems and guidelines to mitigate the problem further. These should be investigated for possible implementation to create more transparency in the event of shortages.