How to investigate levels of Adherence to antiretroviral ... - INRUD

APPENDIX 1 --- Frequently asked questions
A.1
1. Why is it necessary to measure adherence?
Because of the ever present threats of treatment failure and resistance.
2. What use will it be to have a standardized method of measurement?
Standardization is needed so that rates can be compared over time and between facilities. A
manager may know:
How a facility is doing at that moment
How it is doing over time
How it compares to other facilities
To assess the effectiveness of interventions to improve adherence levels.
All of these indicators will, in turn, give a yardstick for managers to concentrate energies
and resources on poorer performing facilities for maximal system strengthening.
3. Why is more than one indicator needed?
The problem with measuring adherence to ARVs is that it is a behaviour that takes place in
the privacy of the patient’s home. Therefore, all measures are indirect and subject to
different biases and inaccuracies. However all of these correlate with clinical outcome.
4. How do we sample facilities?
See Chapter 4, opening paragraph.
5. How do we sample patient records?
Use Figure 1 in Chapter 4.
6. Which dates do we use for dispensing and patient attendance?
Use Table 6 in Chapter 4.
7. Who should we have permission from to do the survey?
The National AIDS Control Programme and/or a local ethical review board.
8. Who should I communicate with in the facilities?
It is important to ask permission from the head of the facility and let the head of the facility
and the head of the HIV/AIDS clinic know your intention. It is often useful to communicate
with the pharmacist to ensure that you are planning your visit on a day when patients are
expected.