This retrospective study assessed the role of hospital pharmacists in the initiation of growth hormone (GH) therapy in an outpatient setting. The study included 28 pediatric patients (< 15 years old) who started GH therapy at our institution between January 2012 and December 2021. Following physician referrals, hospital pharmacists provided medication counseling to the patients and their families. Notably, 6 patients (20%) opted for a specific GH formulation after receiving detailed explanations from the pharmacists. The observed growth velocity (cm/year) and serum IGF-1 (insulin-like growth factor-1) SD scores were comparable to those reported in clinical trials for Norditropin®. Three patients (11%) opted to discontinue treatment. A survey among 5 pediatricians revealed a unanimous agreement that the involvement of hospital pharmacists in outpatient services alleviated their workload during the initiation of GH therapy. Thus, the task of providing medication counseling at the initiation of GH therapy in pediatric patients could potentially be shifted from physicians to pharmacists.

Introduction
One of the challenges related to global health is the imbalanced distribution of health professionals and the HIV/AIDS pandemic. Under this situation, the importance of HIV/AIDS care with health volunteers has been recognized, especially in developing countries, which suffer from the double burden. A task shifting approach is encouraged among health professionals, as well as, between health professionals and non health professionals.
Objective
To discuss supportive surroundings for sustainable HIV/AIDS care with heath volunteers from the perspective of motivation.
Methods
A literature review, where articles were searched and extracted through the PubMed database, was conducted in May, 2010. In total, 16 combinations with 11 keywords were used for searching. (First keyword: motivation, second keyword: HIV or AIDS, third keyword: community health aides, community health workers, community workers, lay counselors, adherence support workers, adherence counselors, care givers or volunteers)
Results
Among the 290 articles extracted, nine articles meeting the criteria of this literature review were selected. Eight articles were reported from developed countries and one article was from a developing country. About half of the study participants in six articles were People With HIV (PWH) or homosexuals. Through all articles, “altruism” and “self development” were recognized as motivation for health volunteers to join and maintain activities. Especially for continuity of activities, “support from other members and staff” and “recognition” were raised. Specific motivation from a developing country was the “ step to formal employment”.
Discussion and Conclusion
Regardless of developed- or developing- countries, fundamental motivation of health volunteers for HIV/AIDS care is similar. However, in developing countries, where health volunteers are adopted as part of the health system, adequate and continuous support and supervision are required more than in developed countries for sustainability of stable care provision. PWH can, also, play an active role as HIV/AIDS care providers by themselves, and they will be a key component for HIV/AIDS care. Further exploration is necessary to determine the motivation of health volunteers for HIV/AIDS care in developing countries where a task shifting approach is encouraged under a shortage of health professionals and HIV/AIDS epidemic.