Master’s in Pharmacy Awarded Cum Laude

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Ms Shimona Prosad graduated with a Master's in Pharmacy degree cum laude for her study entitled: Experiences of Implanon NXT® users at Public Health Facilities in South Africa. Her study, the first in South Africa, has provided evidence that can be used by policymakers to support Implanon NXT® prescription guidelines, counselling protocols and training materials in public health facilities.

Implanon NXT® is a contraceptive implant also known as the “rod”, the “stick” or the Implant. It is inserted under the skin of the upper arm using local anaesthetic, and slowly releases the hormone etonogestrel. It lasts up to three years and possible side effects include dysmenorrhea, new acne, mood swings, headaches and breast tenderness.

Prosad conducted a retrospective, analytical study of data from the national Department of Health Pharmacovigilance Centre for Public Health Programmes, using the case reports submitted from 1 April 2015 to 11 September 2017 with 3 743 cases extracted and analysed. Tests of association were performed using demographics, adverse drug reactions and discontinuation variables. Her findings indicated that 20 -24-year-olds were the most frequent users of the contraceptive implant. Discontinuation was reported by 63.56% of case reports and premature discontinuation was reported by 81.1%.

The main reasons for discontinuation include adverse drug reactions (ADRs), menorrhagia, headaches and dizziness. Interestingly, in Gauteng, the ADRs and other side effects accounted for discontinuation but in KwaZulu-Natal, the main reasons were pregnancy and drug interaction. Prosad also found that premature discontinuation of Implanon NXT® was higher in Gauteng at 82.6% than in KwaZulu-Natal at 76.7%.

Prosad hopes that the evidence from her study will assist in interventions such as educating users on ADRs of Implanon NXT® and raising awareness of the failure of the product. Furthermore, users need to be counselled on the risk of drug interaction with the implant.

Prosad, who was awarded a College of Health Sciences scholarship, thanked her family for their ongoing support: ‘My family always encouraged me to persevere throughout the challenges of my research. Their positivity and moral support gave me strength to achieve my master's. My mom spent many nights siting up with me to proof read my work. My fiancé was my 24-hour IT support centre, and my sister’s sound medical advice guided me.’

She is currently employed in Gauteng as a Pharmacy manager. Her immediate goals include future employment in the pharmacovigilance sector at a pharmaceutical company and if the opportunity presents, pursuing doctoral studies. ‘More immediately, I am busy planning my wedding,’ she said.

Dr Elizabeth Ojewole who supervised the study commented, ‘I am so excited for my student, she worked so hard and deserves the cum laude and more. Shimona Prosad was in my research group of final-year BPharm students at UKZN and was the group leader. She was an exceptional student during her undergraduate research days, and she finished her BPharm degree in 2014. I invited her to pursue a master’s degree. She came back to UKZN in 2017 and pushed her master’s studies nonstop until completion. I am super proud.’

Words: MaryAnn Francis

Photograph: Rajesh Jantilal