The prospective provider must provide evidence that the topics and the associated outcomes have been with complied with as listed in Table 1:
Table 1: Topics covered in the PIMART course with associated outcomes
|
Topic
|
On completion, the student should be able to:
|
|
HIV
|
| (a) |
Apply commonly used medical terminology and acronyms, relevant to this course. |
| (b) |
Demonstrate a sound understanding of the HIV life cycle, CD4 count and viral load meaning, and when to initiate ART. |
| (c) |
Order, perform and interpret HIV tests (rapid, self-screening ELISA and CD-4 tests); i.e. diagnose. |
| (d) |
Describe factors that could influence test results (such as CD-4 count). |
| (e) |
Perform, order or refer and interpret additional, relevant screening tests (tuberculosis1, sexually transmitted infections2, substance abuse and pregnancy tests). |
| (f) |
Order or refer and interpret additional, relevant laboratory screening tests, e.g. baseline creatinine. |
| (g) |
Differentiate between the different WHO staging profiles and be able to classify a patient accordingly. |
| (h) |
Describe the mechanism, clinical presentation and preventative measures relating to Immune Reconstitution Inflammatory Syndrome (IRIS). |
| (i) |
Effectively consult and accurately document patient history, including but not limited to socio-economic profile, medication history, comorbidity profile etc. |
| (j) |
Identify opportunistic infections (in line with WHO staging and most recent NDoH standard treatment guidelines). |
| (k) |
Demonstrate the ability to perform patient assessments based on theoretical guidelines. |
| (l) |
Demonstrate specialised clinical skills by providing authentic proof of practice-based experience and knowledge of HIV test results. |
| (m) |
Effectively and professionally communicate with other members of the healthcare team. |
| (n) |
Identify and professionally refer complicated cases. |
|
|
Prevention of HIV transmission and infection (PrEP and PEP)
|
| (a) |
Demonstrate a clear understanding of the importance, role indications, contra-indications and regimen options of PrEP and PEP. |
| (b) |
Have a thorough knowledge and understanding of basic ARV treatment principles (as applied PMTCT, PrEP or PEP). |
| (c) |
Describe who is eligible for PMTCT, PrEP or PEP. |
| (d) |
Appropriately initiate PMTCT, PrEP or PEP. |
| (e) |
Discuss the general preventative measures against HIV (i.e. condoms, contraceptives). |
| (f) |
Understand the importance of keeping pregnant women HIV negative. |
| (g) |
Understand the role and importance of PMTCT, along with the ability to initiate it. |
| (h) |
Describe methods to ensure safe conception. |
| (i) |
Demonstrate ability to screen for pregnancy. |
| (j) |
Demonstrate a clear understanding of the interactions between ARV and oral contraceptives. |
| (k) |
Elaborate on the association and interaction between STIs and HIV. |
| (l) |
Demonstrate a clear understanding of harm reduction programmes in key populations. |
| (m) |
Demonstrate a clear understanding of the importance, role, and indications of PEP (including the legal requirements in the case of criminal offences) and PrEP. |
|
|
Pharmacological Management of HIV
|
| (a) |
Outline and differentiate between the pharmacological and clinical profiles (including, but not limited to mechanisms of action, side effects and interaction profiles, absolute and relative contraindications, antiviral drug resistance implications and dosing) of the various ARV drugs. |
| (b) |
Have a thorough knowledge and understanding of basic ARV treatment principles (as applied to ART). |
| (c) |
Identify, classify and analyse the different ARV pharmacological profiles. |
| (d) |
Implement the most recent NDoH standard treatment guidelines. |
| (e) |
Apply pre-ART counselling appropriately and initiate ARV treatment regimens. |
| (f) |
Illustrate sound clinical knowledge by means of recommending evidence-based treatment regimens. |
| (g) |
Discuss the importance of treatment adherence for general treatment outcome. |
| (h) |
Effectively and clearly explain the way forward to the patient and what to expect (including, but not limited to expected adverse effects and potential drug-drug interactions, drug allergies, contraindications, and general adherence and risk reduction counselling). |
| (i) |
List complications in the ART era and describe the general approaches to managing these complications. |
|
|
Drug interactions and drug resistance
|
| (a) |
Outline the basic principles of drug interactions and the consequences thereof. |
| (b) |
List the most significant interactions relating to ARV treatment and explain appropriate measures to accommodate or eliminate these interactions. |
| (c) |
Demonstrate an understanding of the mechanism of HIV resistance and understand how resistance is determined clinically. |
| (d) |
Define acquired drug resistance, transmitted drug resistance and pre-treatment drug resistance. |
|
|
Co-morbidities and opportunistic infections related to HIV
|
| (a) |
List and describe co-morbidities (including, but not limited to diabetes, hypertension, asthma, epilepsy, hypercholesterolemia, hyperthyroidism, TB) to be considered in ARV initiated patients. |
| (b) |
Identify opportunistic infections and refer accordingly. |
| (c) |
Discuss recent anti-TB treatment regimens (according to most recent NDoH standard treatment guidelines), their pharmacological profiles and dosage adjustments required when co-administering with ARVs (Including first-line ART, PMTCT, PrEP or PEP). |
| (d) |
Demonstrate knowledge of Hepatitis. |
| (e) |
Demonstrate knowledge of TB prevention. |
|
|
ART data, disease management and referral network
|
|
_______________________________________
1 Pharmacists may not draw blood or order/interpret X-rays, differential diagnosis will only be made based on symptoms and complaints.
2 Pharmacists may not perform physical examination of genital area, differential diagnosis will only be made based on symptoms and complaints.
Eskom Conversion Act, 2001
