The capacity for social media to influence the utilization of re-purposed medicines to manage COVID-19, despite limited availability of safety and efficacy data, is a cause for concern within health care systems. This study sought to ascertain links between social media reports and utilization for three re-purposed medicines: hydroxychloroquine (HCQ), ivermectin and colchicine. A combined retrospective analysis of social media posts for these three re-purposed medicines was undertaken, along with utilization and clinical trials data, in South Africa, between January 2020 and June 2021. In total, 77,257 posts were collected across key social media platforms, of which 6884 were relevant. Ivermectin had the highest number of posts (55%) followed by HCQ (44%). The spike in ivermectin use was closely correlated to social media posts. Similarly, regarding chloroquine (as HCQ is not available in South Africa), social media interest was enhanced by local politicians. Sentiment analysis revealed that posts regarding the effectiveness of these repurposed medicines were positive. This was different for colchicine, which contributed only a small number of mentions (1%). Of concern is that the majority of reporters in social media (85%) were unidentifiable. This study provides evidence of social media as a driver of re-purposed medicines. Healthcare professionals have a key role in providing evidence-based advice especially with unidentifiable posts.

The profession of pharmacy is maturing as a clinical profession in South Africa and has experienced significant development over the past 10 years. The development of clinical pharmacy in Southern Africa started in the late 1980s. The Director-General of Health and Welfare requested an expansion of the pharmacist’s role in Southern Africa, in 1988, when he challenged pharmacists to be “more than just dispensers.” South Africa experience human resource challenges in terms of healthcare service delivery and the shortage of pharmacists has been acknowledged. Due to the human resource shortage, it is very difficult to allocate pharmacists to work in a clinical unit on a daily basis. This document serves to set out practice guidelines for clinical pharmacy in South Africa, and to indicate areas where clinical pharmacist should concentrate to build practice.

The South African Family Practice is a peer-reviewed scientific journal, which strives to provide primary care physicians (and their teams), as well as researchers, with a broad range of scholarly work in the disciplines of family medicine, primary health care, rural medicine, district health and other related fields. SAFP publishes original research, clinical reviews, and pertinent commentary that advance the knowledge base of these disciplines.

Introduction: Clinical pharmacists are crucial for optimizing medication therapy and improving patient outcomes, yet their potential is underutilized in many low- to middle-income countries. Shifting from traditional dispensing to clinical roles requires professional development and identity transformation. In South Africa’s public healthcare system, this shift faces additional challenges, such as a lack of formal positions, limited resources, and role ambiguity. Understanding how clinical pharmacists navigate this transition and develop their clinical identity is essential for their integration into healthcare teams and for improving patient care. Methods: Using a constructivist approach, this qualitative study employed semi-structured interviews with clinical pharmacists (n = 12) across South Africa’s public healthcare sector. We analyzed data through the lens of boundary crossing. Through thematic analysis we explored how pharmacists navigate the complexities of transitioning from dispensing to broader clinical roles, and how these experiences shape their professional identity. Results: Clinical pharmacists navigated both intrapersonal and interpersonal boundaries in their evolving roles. Three key themes were identified: (a) Bridging the gap within: Pharmacists navigate intrapersonal boundaries for clinical identity formation, (b) Bridging the gap between: Pharmacists navigate interprofessional boundaries for collaboration and identity formation, and (c) Building bridges: Pharmacists employ strategies to promote collaboration and recognition. Discussion: This study uncovered the complex interplay between intrapersonal boundaries – such as role ambiguity, self-doubt, reconciling traditional dispensing roles with expanded clinical responsibilities, and the need for mentorship – and interpersonal boundaries, including hierarchical structures, unclear role expectations, limited recognition, and challenges in interprofessional collaboration, in shaping clinical pharmacists’ identities. Fostering boundary crossing competence and interprofessional collaboration can help overcome systemic barriers, enabling pharmacists to navigate their roles, advocate for their expertise, and gain recognition within healthcare teams, ultimately enhancing their integration and improving patient care in resource-constrained settings like South Africa.

Since the outbreak of COVID-19, and its declaration as a pandemic by the World Health Organization (WHO), the reliance on pharmacists as one of the first points of contact within the healthcare system has been highlighted. This evidence-based review is aimed at providing guidance for pharmacists in community, hospital and other settings in South Africa, on the management of patients with suspected or confirmed coronavirus disease 2019, or COVID-19. The situation is rapidly evolving, and new evidence continues to emerge on a daily basis. This guidance document takes into account and includes newly available evidence and recommendations, particularly around the following aspects relating to COVID-19: Epidemiology The virus, its modes of transmission and incubation period Symptom identification, including the differentiation between influenza, allergic rhinitis, sinusitis and COVID-19 Social media myths and misinformation Treatment guidelines and medicines that may need to be kept in stock Treatment and prevention options, including an update on vaccine development The case for and against the use of NSAIDs, ACE-inhibitors and angiotensin receptor blockers (ARBs) in patients with COVID-19 Interventions and patient counselling by the pharmacist. It is critical, though, that pharmacists access the most recent and authoritative information to guide their practice. Key websites that can be relied upon are: World Health Organization (WHO): https://www.who.int/emergencies/diseases/novel-coronavirus-2019 National Institute for Communicable Diseases (NICD): https://www.nicd.ac.za/diseases-a-z-index/covid-19/ National Department of Health (NDoH): http://www.health.gov.za/index.php/outbreaks/145-corona-virus-outbreak/465-corona-virus-outbreak; https://sacoronavirus.co.za/