Iyeza Health, 4 Phatha Close, Harare Business Square, Khayelitsha, Cape Town, South Africa.
School of Pharmacy, University of the Western Cape, Private bag X17, Bellville, Cape Town, South Africa.
BMC Fam Pract. 2021 Feb 22;22(1):43. doi: 10.1186/s12875-021-01392-1.
Chronic patients are required to access their chronic medicines on a regular basis, often only to refill their repeat prescriptions. Adherence to chronic medicines is challenging and has stimulated health care providers to devise differentiated service delivery models of care to decentralise chronic medicine distribution to decrease the frequency of medicine collection at health care facilities. One such option includes a last kilometre medicine delivery service. This study investigated chronic patients' preferences for a last kilometre medicine delivery service model.
An exploratory non-randomised quantitative study was conducted over 4 weeks at four public sector primary health care facilities in Cape Town, South Africa. Data was collected on a structured questionnaire from chronic patients queuing to receive medication at each facility's pharmacy waiting area. Patient demographics were noted to align with preferences for chronic medicine service delivery characteristics including; mobile ordering, fee for service and location for delivery. Chi-square test and frequencies were employed to analyse data using SPSS version 23.
A total of 116 patients participated in this study. Most were interested in a medicine delivery service (80.2%) and were willing to use a mobile application to order their medicines (84.5%). Almost all patients (96.8%) preferred that their medicines be delivered to their home. More than three quarters of participants were willing to pay for the service (77.6%). Chi-square test showed that gender, age group, employment status, distance to the health facility and /or average waiting time at the clinic significantly influenced the preference for certain characteristics of the medicine delivery service (p < 0.05).
Most participants were interested in a last kilometre medicine delivery service, especially those older than 45 years, waiting for more than 6 h at the facility, and staying within one kilometre radius of the clinic. More studies are needed to establish the influence of patients' employment status and the distance to health facility on interest in the medicine delivery service.
慢性患者需要定期获取他们的慢性病药物，通常只是为了补充他们的重复处方。遵守慢性病药物治疗具有挑战性，这促使医疗保健提供者设计差异化的服务提供模式来分散慢性病药物的分发，以减少在医疗保健机构收集药物的频率。其中一种选择是最后一公里的药物配送服务。本研究调查了慢性患者对最后一公里药物配送服务模式的偏好。
在南非开普敦的四家公立初级保健设施进行了为期 4 周的探索性非随机定量研究。在每个设施药房等候区排队取药的慢性患者中，使用结构化问卷收集数据。患者的人口统计学数据与慢性病服务提供特征的偏好相匹配，包括：移动订购、服务收费和交付地点。使用 SPSS 版本 23 中的卡方检验和频率分析数据。
共有 116 名患者参加了这项研究。大多数患者对药物配送服务感兴趣（80.2%），并愿意使用移动应用程序订购他们的药物（84.5%）。几乎所有患者（96.8%）都希望将药物送到他们家中。超过四分之三的参与者愿意为此服务付费（77.6%）。卡方检验表明，性别、年龄组、就业状况、到医疗机构的距离和/或在诊所的平均等待时间显著影响了对药物配送服务某些特征的偏好（p<0.05）。
大多数参与者对最后一公里药物配送服务感兴趣，特别是年龄在 45 岁以上、在设施等待时间超过 6 小时、且距离诊所半径在一公里以内的患者。需要进一步研究以确定患者的就业状况和到医疗机构的距离对药物配送服务兴趣的影响。
