/ 8 December 2023

A healthcare world that is alive and well

Lee Callakoppen, principal officer of Bonitas Medical Fund.

Professional help is becoming easier to access – starting with your local pharmacy

Over the years, pharmaceutical outlets have been reinventing themselves to offer broader consumer product offerings, including beauty products, white goods (large appliances) and personal healthcare products. Now they have become entrenched as partnership extensions of medical aids, offering holistic healthcare services to the public — whether they are covered by a medical aid or not.

“Clicks will continue to add products, services and offerings that add value and convenience to the lives of our customers, expanding our clinical service offerings and focusing on technological solutions that help to meet customers wherever they are,” says Rachel Wrigglesworth, Clicks Chief Healthcare Officer.

“This has been a great strategy for the pharmaceutical outlets: to increase and improve their value chain,” adds Keyhealth Medical Scheme’s CEO, Patrick Masobe. Pharmacies now also provide health screening services, employee and mother and baby wellness clinics and clinic nurse services as well as virtual doctor consultations, to mention a few.”

Asked how he sees pharmacies adapting to the tabled NHI, Masobe says: “Pharmacies and pharmacy clinics are often the first port of call for people needing medical assistance. The NHI white paper indicates that the government intends to utilise all available professional public and private resources to achieve a universal healthcare system in South Africa. I see pharmacies being heavily involved in the transformation of the way the government intends to provide services.”

Festive season disruption

The festive season can be perceived as a serious health disruptor: patterns indicate that even those with chronic conditions overindulge in a way that can be very harmful to their health.

“We drive medicine adherence over the festive season with our convenient centralised database, a range of medication management services and our festive wellness guide, which speaks to enjoying the festive season with your health top of mind,” says Wrigglesworth. “All Clicks pharmacies are sufficiently stocked, no matter the time of the year, and with our centralised database customers can collect their medication at any one of over 700 Clicks pharmacies across South Africa. However, we do advise customers to stock up on medication should they plan to travel somewhere remote and are concerned that they may not have enough medication to last them.”

Masobe says Keyhealth assists its pharmacist network in advising its patronage to manage chronic conditions such as high blood pressure and diabetes. He says its condition-specific care and treatment plans can be shared with the pharmacist and any related health professional who is part of the multidisciplinary team that assists with managing members’ registered chronic conditions.

“Pharmacists play a key role in patient education, and we encourage them to offer clinical advice, promote health and to manage a healthy lifestyle. Over the festive season our pharmacy partners and their nurses will be keeping the same operating hours and walk-in care service levels. There will also be nurses available for virtual online consultations, available during a pharmacy’s usual operating hours, seven days a week.

“Nurses can also link members to a video consultation with a doctor on call should a member require further consultation, a repeat of prescription, a sick note, or if necessary, [we can] refer them to a specialist,” says Wrigglesworth.

Healthcare in the digital world

Technology has become pivotal in the healthcare industry and medical aids, pharmacies and medical service providers are all constantly working on improving technology systems to provide a better experience for stakeholders. Technology is being enhanced to create electronic health records and make digital platforms able to provide a seamless user experience. Online portals, mobile applications, and other digital channels are striving to make it easier for stakeholders to access and manage all their relevant information.

Patrick Masobe, CEO of Keyhealth.

Wrigglesworth says the company’s digital offerings include the Clicks app, which allows customers to order medication, choose collection or delivery, and access other services like viewing their digital ClubCard.

“We also have a convenient online clinic booking service and an affordable virtual doctor service, which includes a video consultation with a qualified healthcare practitioner. We are about offering customers convenience, value and choice, and offer customers both digital and face-to-face interaction.

“The use of technology brings convenience for customers in a mobile age, and services are created to remove points of friction in the pharmacy journey. Examples of this include the Pharmacy Chat service and Clicks’ Repeat Prescription Service, which offers customers convenient SMS reminders and a choice between in-store collection, smart locker collection or on-demand delivery.”

According to Masobe, the kinds of technology differentiators they are seeing emerging in the pharmacy arena include artificial intelligence (AI), immersive technologies such as augmented reality (AR) and virtual reality (VR), and various automation technologies.

“Pharmacies that embrace these technologies may be able to enhance patient engagement, improve workflows, increase patient safety and simplify communication. The market for new technologies is booming in the pharmacy industry,” says Masobe.

“Clicks works closely with medical aids to ensure service offerings meet the needs of the medical scheme and that dispensing of medicines is in line with what is covered by each scheme,” says Wrigglesworth. “This helps member benefits last longer. We also closely support doctors and hospitals by ensuring patients can be serviced quickly and professionally, and may contact the patient’s healthcare provider if there is a query regarding treatment or a prescription.

“Clicks is a preferred service provider to most medical schemes and a designated service provider to other medical schemes,” she concludes.

Mental health in the ‘festive’ season

It might be the season to be jolly, but the reality is that the festive season can have a very negative impact on your mental health and cause or augment depression — particularly if you are alone, have family overseas or are estranged from family or friends for whatever reason. Loneliness can be a significant suicide trigger.

The South African Depression and Anxiety Group (SADAG) says that in October 2023 its helplines were receiving up to 3 000 calls daily and hundreds more emails, SMSs, WhatsApps and social media messages from people reaching out for help and support. This is expected to increase during December and over the festive season due to financial pressure, feelings of abandonment and stress-inducing family time. Added to this is the usual surge of gender-based violence and substance abuse.

According to Bonitas Medical Fund, one in six South Africans suffer from anxiety, depression or substance use disorder and over the last two years, the prevalence of anxiety and depression disorders has increased by 36.4% and 38.7% respectively. Globally more than 970 million people have a mental health or substance abuse disorder.

“One of the key insights we have noted is that the prevalence of mental health disorders in both men and women is at an all-time high,” says Lee Callakoppen, principal officer of Bonitas Medical Fund.

“This is exacerbated by factors such as an increased economic burden, poor socioeconomic conditions and increased psychosocial challenges such as load-shedding.

“We have seen a 25% increase in the number of mental health hospital admissions, indicating a need for additional support. This need is particularly high in the 18 to 44 age groups. We further noted that mental health was a key driver for absenteeism in corporate groups. This has a massive effect on employers as they try to cope with keeping their businesses going, preventing job losses and maintaining a happy and motivated workforce.

“This led us to including the Bonitas Mental Healthcare Programme across all plans, with depression included as a chronic condition. We also offer access to Panda, a free digital platform that gives members anonymous, easy and confidential access to expert help, mental health information and community support.”

Poor mental health is a genuine health condition

Mental illness is not gender-specific: it affects both men and women. Through centuries of stereotyping with notions of masculinity, men may face specific challenges and stigmas related to mental health, and find it more difficult to express emotions or seek help for mental health issues. Suicide statistics indicate that men are more likely to commit suicide than women in South Africa.

Rachel Wrigglesworth, Clicks Chief Healthcare Officer.

But mental illness is not a character defect; it is a health problem just like arthritis, diabetes, high blood pressure or cancer. The Bonitas clinical team says that fear and misunderstanding often lead to prejudice against people with mental illness and addiction, which is a serious barrier to diagnosis and treatment.

They say anxiety disorders and depression are the most common mental health problems, but others include eating disorders, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), bipolar mood disorder, as well as psychotic disorders like schizophrenia and personality disorders. Substance and alcohol abuse is also classified under mental illness. Unfortunately, mental health conditions are often under-reported and untreated due to the stigma associated with them.

According to South Africa’s National Mental Health Policy Framework, up to 80% of South Africans who need mental health support cannot easily access it, particularly in rural regions. However, these days people can turn to nearby peripheral healthcare service providers — a pharmacist, for example, may be able to provide some advice and help with medication that doesn’t require a prescription.

Medical schemes such as Discovery, Keyhealth and Bonitas are taking the mental health problem very seriously and are working hard to address the problem, creating awareness and a culture of empathy among its service providers towards improving quality of life and empowering people with mental health issues to manage their condition.

Through government regulation, there are mental health programmes in place via medical aids and most mental illnesses can be effectively treated by health professionals and community-based services or NGOs. This may include access to medication, therapy and counselling.

Studies indicate that suicide rates do increase in the summer holidays, when there are typically changes in social activities. The consensus of medical aids and medical service providers is that if someone is experiencing symptoms of a mental illness, such as having suicidal thoughts, or they know someone who is struggling with these symptoms — identifiable through uncharacteristic behavioural changes like social withdrawal and unusual emotional patterns — it is important to seek professional help.

The good news is that there are “always open” mental healthcare providers, virtual platforms and independent organisations available, including SADAG, PsychMatters Centre, Lifeline and Childline.

Limit the impact of the festive season on chronic illness

Synonymous with the festive season is the desire to overindulge — not a good idea for those with a chronic illness. But there are ways for those with a chronic illness to navigate the festive season, according to holistic health coach Anya Zander.

“Plan ahead and be prepared. Inform your host what you can and cannot eat and bring your own meal if necessary,” says Zander. “If you’re going to an event that will be serving snacks or finger food, try to eat a small meal before you go that includes some protein and healthy fat, or have a protein shake or even a boiled egg, if you can eat egg. This will help you not to feel hungry so that you make better choices and will help to balance blood sugar if tempted to eat sweet treats.”

Zander stresses the importance of staying hydrated and drinking lots of water, especially if you’re planning on having a glass of wine.

“If you are going to a big celebratory dinner or lunch and you don’t want to be too restrictive, then eat consciously and slowly, which will help you to eat less and assist the digestive process. A good tip to stabilise your blood sugar is to first eat your greens — preferably a salad — then your protein and lastly the carbohydrates.

“Conscious eating slowly will help you to eat less and will help ease the digestive process. Drinking a glass of water 15 minutes before your meal will help you to feel fuller so you will eat and crave less traditional meal indulgences.

“Do enjoy your meal without guilt and if you overindulge, don’t beat yourself up — be kind to yourself and just get back on track with your next meal.”

According to Zander, going for a walk after a meal will help stabilise blood sugar. A family walk after Christmas lunch will help everyone to feel a lot better.

“Sometimes during the festive season you may need to create some physical and mental health boundaries. If you need space, go for a walk, step outside, say no or just take a few deep breaths. Be your own advocate and know your limits. You are responsible for your own health.

“However, most importantly, have fun being with your family and friends. Being with family, friends and community is medicine too,” she concludes.

Contact numbers

South African Anxiety and Depression Group (SADAG): 0800 567 567

PsychMatters Centre: 062 975 8442

Lifeline: 011 715 2000

Childline: 031 201 2059