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

How to Investigate Adherence to Antiretroviral Treatment:
An Indicator-Based Approach
practice, the recall period they may have asked about could vary from their adherence
yesterday to since the last clinic visit.
The indicator chosen here using self-reporting is the same as used from exit interviews.
Self Report 1.
Percentage of patients with full adherence to ART (i.e., no doses missed
in the recall period, which is three days in the INRUD-IAA methodology)
Rationale
Source of data
Data collection
Perfect (or > 95%) adherence is the primary treatment goal.
Patient self-report—―In the last 3 days (or at least a standardized number of
days) have you missed any of the ARV doses you were supposed to take?‖
(Response: Y/N)
Pharmacy or clinical records based on the same sample of 100 patient records
sampled for the core indicators.
Computation (# of patients responding N/# of patients asked) × 100.
Comments
Pitfalls
Question can be asked for last 1, 2, 3, 4, or 7 days. For any of these periods,
this indicator is the equivalent of the 95% adherence rate (missing 1 dose in 7
days is 7.7% of doses on a twice daily regimen). Calculation can be the same if
the question is asked for 30 days or for the period since last clinic visit, but
interpretation would differ.
The only hope of getting an honest answer is if the interviewer or clinician is
friendly and non-officious. Interviewers or clinicians need to be trained to ask
the question in a uniform way.
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