ArticleAfrican journal of primary health care & family medicine2026
Management of progressive joint disorders by non-physician healthcare providers in South Africa: A mapping study to inform pharmacist integration.
Article in African journal of primary health care & family medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProgressive joint disorders (PJDs), including osteoarthritis, rheumatoid arthritis (RA) and are leading causes of disability worldwide. Early multidisciplinary intervention is critical; however, delayed non-pharmacological management, fragmented referral pathways and limited integration of pharmacists, despite their potential role in medication management and early 'red flag' identification, remain common.
aimTo identify which PJDs are managed by which healthcare providers, to inform pharmacist referral pathways and promote integrated care.
settingNon-physician healthcare providers (HCPs) in South Africa, including physiotherapists, occupational therapists, chiropractors, podiatrists, osteopaths, biokineticists and other complementary therapy providers.
methodsA quantitative, cross-sectional survey was administered via REDCap® and distributed by professional bodies through email and professional association platform advertisements. Descriptive statistics and quantitative content analysis assessed condition management, referral practices and collaboration.
resultsA total of 266 HCPs participated. Osteoarthritis (91.7%) and RA (84.6%) were the most managed conditions. High interprofessional collaboration was noted with physiotherapists (71.4%) and limited with pharmacists (23.3%). Most providers (76.3%) did not require referral letters. Referrals to and from other providers were common, but incoming referrals varied by profession. Internal consistency was acceptable (Cronbach's α 0.70).
conclusionProgressive joint disorders were predominantly managed by chiropractors, physiotherapists and biokineticists. Referral pathways were inconsistent, and pharmacist integration remained limited.Contribution: This study presents the first national mapping of non-physician roles in PJD management in South Africa, providing critical insights for future development of pharmacist-inclusive referral guidelines.
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