Bachelor of Pharmacy syllabi in South Africa: Missed opportunity for multidisciplinary management of musculoskeletal conditions
DOI:
https://doi.org/10.46542/pe.2025.251.502513Keywords:
Healthcare team, Integration of pharmacist, Interprofessional education, Joint disease, Non-pharmacological management, Referral by pharmacistAbstract
Background: Musculoskeletal (MSK) conditions decrease quality of life and burden healthcare systems. Pharmacists are well placed to reduce the burden on the healthcare system and contribute to multidisciplinary teams. Pharmacy graduates need to possess the knowledge and skills to seamlessly collaborate with multidisciplinary teams by understanding the role of other healthcare professionals (HCPs). Thus, this study aimed to evaluate whether the various offerings of the South African Bachelor of Pharmacy (BPharm) degree effectively familiarise graduates with other HCPs and their roles using MSK conditions as a theme.
Methods: A comparative cross-sectional desktop review was conducted across all nine South African universities offering the BPharm degree. Curriculum documents and teaching materials were analysed using qualitative content analysis. Themes were identified using open coding.
Results: The commonly covered MSK conditions were gout, osteoarthritis, rheumatoid arthritis, trauma, and sports-related injuries. All universities addressed non-pharmacological management. Physiotherapists, medical doctors, and occupational therapists were the most frequently mentioned HCPs, however, only one university addressed their roles and responsibilities.
Conclusion: Graduates often lack clarity on referring MSK cases, hindering interdisciplinary collaboration. To enhance teamwork, interdisciplinary education should be integral to the undergraduate curriculum. Pharmacy syllabi must include healthcare professional roles and non-pharmacological strategies. Accrediting bodies and universities should promote interdisciplinary education and collaboration.
References
Asim, M., Azim, M. E., Siddiqi, F. A. & Rathore, F. A. (2024). Multimodal approach to address the multifaceted nature of Chronic Musculoskeletal Disorders: Bridging the gap between research and clinical practice. Journal of the Pakistan Medical Association, 74(6), 1199–1201. https://doi.org/10.47391/jpma.24-44
Ayele, A. A., Mekuria, A. B., Tegegn, H. G., Gebresillassie, B. M., Mekonnen, A. B., & Erku, D. A. (2018). Management of minor ailments in a community pharmacy setting: Findings from simulated visits and qualitative study in Gondar town, Ethiopia. PLoS ONE, 13(1), 1–11. https://doi.org/10.1371/journal.pone.0190583
Batt, A. M., Williams, B., Brydges, M., Leyenaar, M., & Tavares, W. (2021). New ways of seeing: supplementing existing competency framework development guidelines with systems thinking. Advances in Health Sciences Education, 26(4), 1355–1371. https://doi.org/10.1007/s10459-021-10054-x
Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlus Open, 2(1), 8–14. https://doi.org/10.1016/j.npls.2016.01.001
Blyth, F. M., Briggs, A. M., Schneider, C. H., Hoy, D. G., & March, L. M. (2019). The global burden of musculoskeletal pain-where to from here? American Journal of Public Health, 109(1), 35–40. https://doi.org/10.2105/AJPH.2018.304747
Bobbins, A. C., Burton, S., & Fogarty, T. (2020). Different models of pharmaceutical services and care in primary healthcare clinics in the Eastern Cape, South Africa: Challenges and opportunities for pharmacy practice. African Journal of Primary Health Care and Family Medicine, 12(1), 1–11. https://doi.org/10.4102/phcfm.v12i1.2323
Briggs, A. M., Woolf, A. D., Dreinhöfer K., Homb, N., Hoy, D. G., Kopansky-Giles, D., Åkesson, K., & March, L. (2018). Reducing the global burden of musculoskeletal conditions. Bull World Health Organization, 96(5), 366–368. https://doi.org/10.2471/BLT.17.204891
Clayton, K., Luxford, Y., & Stupans, L. (2023). Attitudes and knowledge of community pharmacists toward complementary and alternative medicine: A narrative review. Alternative Therapies Health and Medicine, 29(3), 274–281. https://pubmed.ncbi.nlm.nih.gov/33421041/v
Cottrell, E., Stanford, C., Quicke, J., Dziedzic, K., Sommerville, S., & Ashworth, J. (2021). Appropriate community pharmacy management of joint pain. The Pharmaceutical Journal, 307(7953), 1–15. https://doi.org/10.1211/PJ.2021.1.91555
Crafford, L., Kusurkar, R., Bronkhorst, E., Gous, A. G. S., & Wouters, A. (2023). Understanding of healthcare professionals towards the roles and competencies of clinical pharmacists in South Africa. BMC Health Services Research, 23(290), 1–11. https://doi.org/10.1186/s12913-023-09222-z
De La Rosa, J. S., Brady, B. R., Ibrahim, M. M., Herder, K. E., Wallace, J. S., Padilla, A. R., Vanderah, T. W. (2024). Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities. PAIN, 165(3), 666–673. https://doi.org/10.1097/j.pain.0000000000003056
Dineen-Griffin, S., Benrimoj, S. I., & Garcia-Cardenas, V. (2020). Primary health care policy and vision for community pharmacy and pharmacists in Australia. Pharmacy Practice (Granada), 18(2), 1–9. https://doi.org/10.18549/PharmPract.2020.2.1967
El-Awaisi, A., Joseph, S., El-Hajj, M. S., & Diack, L. (2018). A comprehensive systematic review of pharmacy perspectives on interprofessional education and collaborative practice. Research in Social and Administrative Pharmacy, 14(10), 863–882. https://doi.org/10.1016/j.sapharm.2017.11.001
Engelbrecht, D., Thandar, Y., & Venketsamy, Y. (2024). Analgesic self-medication among patients with chronic musculoskeletal pain in a South African chiropractic teaching clinic: A cross-sectional study. Journal of Chiropractic Medicine, 1(1), 1–12. https://doi.org/10.1016/j.jcm.2024.02.002
Garbi M. (2021). National Institute for Health and Care Excellence clinical guidelines development principles and processes. Heart (British Cardiac Society), 107(12), 949–953. https://doi.org/10.1136/heartjnl-2020-318661
Gilchrist, R., & Kholvadia, A. (2023). Team approach to osteoarthritis management: Viewpoints of biokineticists and physiotherapists in South Africa. South African Journal of Sports Medicine, 35(1), 1–11. https://doi.org/10.17159/2078-516x/2023/v35i1a15260
Gregory, T., & Gregory, L. (2020). The role of pharmacists in safe opioid dispensing. Journal of Pharmacy Practice, 33(6), 856–862. https://doi.org/10.1177/0897190019852803
Harnett, J. E., & Ung, C. O. L. (2023). Towards defining and supporting pharmacists' professional role associated with traditional and complementary medicines – A systematic literature review. Research in Social and Administrative Pharmacy, 19(3), 356–413. https://doi.org/10.1016/j.sapharm.2022.11.001
Kerr, A., O'Connor, H., Pawlikowska, T., Gallagher, P., & Strawbridge, J. (2020). A scoping review of health professional syllabi: Implications for developing integration in pharmacy. Research in Social and Administrative Pharmacy, 16(1), 1–16. https://doi.org/10.1016/j.sapharm.2019.03.005
Khaira, M., Mathers, A., Benny-Gerard, N., & Dolovich, L. (2020). The evolving role and impact of integrating pharmacists into primary care teams: Experience from Ontario, Canada. Pharmacy, 8(4), 1–10. https://doi.org/10.3390/pharmacy8040234
Kiles, T. M, Peroulas, D., & Borja-Hart, N. (2022). Defining the role of pharmacists in addressing the social determinants of health. Research in Social and Administrative Pharmacy, 18(1), 3699–3703. https://doi.org/10.1016/j.sapharm.2022.01.005
Kligler, B., Bair, M. J., Banerjea, R., DeBar, L., Ezeji-Okoye, S., Lisi, A., Murphy, J. L., Sandbrick, F., & Cherkin, D. C. (2018). Clinical policy recommendations from the VHA State-of-the-Art Conference on non-pharmacological approaches to chronic musculoskeletal pain. Journal of General Internal Medicine, 33(1), 16–23. https://doi.org/10.1007/s11606-018-4323-z
Laguna, J. M., Puhan, M. A., Artalejo, F. R., De Pauw, R., Wyper, G. M. A., Devleesschauwer, B., Santos, J. V., & Hincapié, C. A. (2023). Certainty of the global burden of disease 2019 modelled prevalence estimates for musculoskeletal conditions: A meta-epidemiological study. International Journal of Public Health, 68(1), 1–12. https://doi.org/10.3389/ijph.2023.1605763
Lamper, C., Beckers, L., Kroese, M., Verbunt, J., & Huijnen, I. (2021). Interdisciplinary care networks in rehabilitation care for patients with chronic musculoskeletal pain: A systematic review. Journal of Clinical Medicine, 10(9), 1–64. https://doi.org/10.3390/jcm10092041
Lewi, J. S., Cook, C.E., Hoffmann, T. C., & O'Sullivan, P. (2020). The elephant in the room: Too much medicine in musculoskeletal practice. Journal of Orthopaedic & Sports Physical Therapy, 50(1), 1–4. https://doi.org/10.2519/jospt.2020.0601
Lewis, R., Gómez-Álvarez, C. B., Rayman, M., Lanham-New S., Woolf, A., & Mobasheri, A. (2019). Strategies for optimising musculoskeletal health in the 21st century. BMC Musculoskeletal Disorders, 20(164), 1–15. https://doi.org/10.1186/s12891-019-2510-7
Maslyankov, I., Wang, Y.-Y., Bowie, D., Heaney, J., & Chalkidou, A. (2022). OP36 A lifecycle approach in evaluating medical technologies: Insights from The National Institute for Health and Care Excellence Guidance review process. International Journal of Technology Assessment in Health Care, 38(S1), S15–S15. https://doi.org/10.1017/s0266462322000939
McLachlan, A. J., Carroll, P. R., Hunter, D. J., Wakefield, T. A. N., & Stosic, R. (2022). Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey. Health Expect, 25(1) 936–946. https://doi.org/10.1111/hex.13429
Meda, R. T., Nuguru, S. P., Rachakonda, S., Sripathi, S., Khan, M. I., & Patel, N. (2022). Chronic pain-induced depression: A review of prevalence and management. Cureus, 14(8) 1–9. https://doi.org/10.7759/cureus.28416
Miller, F. W. (2023). The increasing prevalence of autoimmunity and autoimmune diseases: An urgent call to action for improved understanding, diagnosis, treatment, and prevention. Current Opinion in Immunology, 80(1) 1–16. https://doi.org/10.1016/j.coi.2022.102266
Mosiane, T., Nkonde, K., Mahlatsi, G., & Mncwangi, N. P. (2023). A review on pharmacy practice in South Africa—A higher education perspective. Pharmacy, 11(1), 3. https://doi.org/10.3390/pharmacy11010003
Nielsen, R. B., N., Johansen, S. K., Andreasen, J., Palsson, T. S., Carlsen, A., & Rathleff, M. S. (2025). Integrating physiotherapists, occupational therapists, and psychologists in the management of chronic and complex musculoskeletal pain in the municipality – a workshop study. Musculoskeletal Science and Practice, 78(1), 1–13. https://doi.org/10.1016/j.msksp.2025.103336
Pearson, M. L., & Hubball, H. T. (2012). Curricular integration in pharmacy education. American Journal of Pharmaceutical Education, 76(10), 1–8. https://doi.org/10.5688/ajpe7610204
Perrot, S., Cittée, J., Louis. P., Quentin, B., Robert, C., Milon, J., Bismut, H., & Baumelou, A. (2019). Self-medication in pain management: The state of the art of pharmacists’ role for optimal Over-The-Counter analgesic use. European Journal of Pain, 23(10), 1747–1762. https://doi.org/10.1002/ejp.1459
Safo, A. A. A. N., Okoro, O. N., & Attakorah, J. (2022). Perceptions of healthcare providers about pharmacists' clinical roles in patient care in Ghana. Innovations in Pharmacy, 13(4), 1–8. https://doi.org/10.24926%2Fiip.v13i4.5018
Saragih, I. D., Hsiao, C., Fann, W., Hsu, C., Saragih, I. S., & Lee, B. (2024). Impacts of interprofessional education on collaborative practice of healthcare professionals: A systematic review and meta-analysis. Nurse Education Today, 136(1), 1–8. https://doi.org/10.1016/j.nedt.2024.106136
Schot, E., Tummers, L., & Noordegraaf, M. (2019). Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 332–342. https://doi.org/10.1080/13561820.2019.1636007
Shapovalov, V., Piontkovskyi, V., & Huzovatyi, O. (2023). An interdisciplinary approach to development of a new combined medicine for musculoskeletal disorders. SSP Modern Pharmacy and Medicine, 3(4), 1–17. https://doi.org/10.53933/sspmpm.v3i4.115
Sharma, D., Gupta, R., & Gaba, P. (2022). Pain management by alternative therapies and herbal bioactive. World Journal of Biology Pharmacy and Health Sciences, 12(03), 370–383. https://doi.org/10.30574/wjbphs.2022.12.3.0283
Sim, T. F., Hattingh, H. L., Sunderland, B., & Czarniak, P. (2020). Effective communication and collaboration with health professionals: A qualitative study of primary care pharmacists in Western Australia. PLoS ONE, 15(6), 1–20. https://doi.org/10.1371/journal.pone.0234580
South African Pharmacy Council. (2017). Good Pharmacy Education Standards (GPES). https://www.pharmcouncil.co.za/media/default/documents/Good_Pharmacy_Education_Standards_(HET)_(2017).pdf
South African Pharmacy Council. (2019). Good Pharmacy Education Standards (GPES). https://pharmcouncil.co.za/Media/Default/Documents/BN32 of 2019 - Amendments to Good Pharmacy Education Standards - HET.pdf
South African Pharmacy Council. (2024). Bachelor of Pharmacy curriculum outline and criteria for accreditation: Exit level outcomes, associated assessment criteria and constructive alignment. https://pharmcouncil.co.za/Media/Default/Board%20Notices/BN544%20BPharm%20Curriculum%20Outline%20and%20Criteria%20for%20Accreditation_proposed.pdf
Takahashi, N., Takatsuki, K., Kasahara, S., & Yabuki, S. (2019). Multidisciplinary pain management program for patients with chronic musculoskeletal pain in Japan: a cohort study. Journal of Pain Research, 12(1), 2563–2576. https://doi.org/10.2147/jpr.s212205
Tan, M. L., Heng, M., Ker, P. T. S., & Lim, J. W. (2025). Work-related musculoskeletal disorders among podiatrists in Singapore. Journal of the American Podiatric Medical Association, 115(1), 1–26. https://doi.org/10.7547/23-217
Thapa, P., Lee, S. W. H., Kc, B., Dujaili, J. A., Mohamed-Ibrahim, M. I., & Gyawali, S. (2021). Pharmacist-led intervention on chronic pain management: A systematic review and meta-analysis. British Journal of Clinical Pharmacology, 87(8), 3028–3042. https://doi.org/10.1111/bcp.14745
Tornqvist, T., Falk, A. L., & Tongstrom, P. (2023). Sharing knowledge: Final-year healthcare students working together at an interprofessional training ward. Journal of Interprofessional Education & Practice, 33(1), 1–9. https://doi.org/10.1016/j.xjep.2023.100670
Udoh, A., Ernawati, D. K., Akpan, M., Galbraith, K., & Bates, I. (2020). Pharmacies and primary care: A global development framework. Bull World Health Organ, 98(11), 809-811. https://doi.org/10.2471/BLT.19.248435
Umberto, M. (2023). The Mazzanti AcuOsteo Method®: Pathology and treatment with acupuncture and osteopathy of the musculoskeletal pain of the upper and lower limbs. Perspectives on Integrative Medicine, 2(2), 126–130. https://doi.org/10.56986/pim.2023.06.007
