African Journals OnLine
South African Family Practice

Volume 25 Number 5, 2002

How to design education on mental disorders for general practitioners in South Africa 

Objective: This study looks at how the WHO programme Mental Disorders in Primary Care should be adapted for GPs in the South African context in order to positively impact the recognition and management of mental disorders. 
Design: Participatory action research was used to adapt the WHO programme. There were 3 phases to the study. Firstly a co-operative inquiry group of 10 GPs adapted the WHO materials. Secondly the findings of the inquiry were incorporated into the design of a web-based distance education programme. Thirdly the web-based programme was evaluated by means of an action inquiry with the 21 registered GPs. Setting: South African general practitioners working in both public and private practice. Results: The findings of the study are presented as a model of the primary care consultation with a specific focus on the recognition and management of mental disorders. The approach includes the use of one hypothesis for ‘mental problems’ and assessment in the ‘lobby’ of general practice. Sixgoverning variables for this approach are described: cues, communication skills, continuity of care, confidence, course tools and community resources. 
Conclusion: This study presents a practical model of the primary care consultation, which focuses on an approach to the recognition and management of mental disorders. This model has been used to adapt the WHO programme for the South African context. The model may be of use to general practitioners, educational designers, teachers of family medicine /primary care as well as district managers who wish to enhance the quality of care for patients with mental disorders.

Die toksikologiese telefoniese konsultasies gerig aan die Departement Farmakologie van die Universiteit van die Vrystaat gedurende 1998/ The toxicology telephonic consultations directed to the department of pharmacology of the University of the Free State during 1998 

Background: Epidemiologic surveys of poisonings as well as enquiries regarding poisonings are necessary to obtain information for the combating as well successful medical management of poisonings. Methods: All telephonic consultations regarding poisonings from 1 January 1998 to 31 December 1998 of two of the four consultants of the toxicology centre of the Department of Pharmacology at the University of the Free State were studied retrospectively. Information was noted on a coding form from the consultation forms of the consultants. 
Results: 994 consultations were included in the study. Most consultations were on Mondays (20.7%), after hours (68.6%) and by general practitioners (33.7%) and registrars (32.1%). Of the enquiries 58.4% was with regard to intentional intake. Medications were responsible for 55.7% of enquiries, followed by household products (27.6%) and agricultural products (10.4%). Paracetamol (10.9%) was the most common medication, followed by benzodiasepine (9.9%) and organophosphate (8.7%). Central nervous system medications were involved in 23.3% of the enquiries, and pain medication in 15.9%. 
Conclusion: Undergraduate and postgraduate training of doctors should place sufficient emphasis on the most common types of poisonings and medication overdosages.