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

How to Investigate Adherence to Antiretroviral Treatment:
An Indicator-Based Approach
Rationale
Source of data
Data collection
Computation
Comments
To provide optimal care in line with national policies it is advantageous to have
guidelines that can be followed.
Facility interview.
While doing the facility interview ask to see copies of the different guidelines.
If you can’t hold them in your hand they are not there.
National ART treatment guidelines—The presence of a national ART treatment
guidelines.
Donor ART treatment guidelines—The presence of a donor ART treatment
guidelines.
ART storage guidelines—The presence of an ART storage guidelines.
Clinical guidelines for starting patients on ART—Whether the facility manager
says that the facility follows the clinical guidelines for starting patients on ART.
The presence of written guidelines does not mean they are being followed.
2. Quality of treatment
10. Adherence to STGs—Percentage of patients whose current treatment is consistent
with national STGs
Rationale
Patients treated according to established guidelines for ARVs are more likely to
be adherent to care.
Source of data Clinical records for the sample of 100 patients in indicators 4–10.
Data collection
Computation
Comments
Patient clinical records are examined to determine if current treatment is
consistent with national STG for selection and dosing of ARVs.
(Number of patients whose last treatment was consistent with STGs/number of
patients records examined) × 100.
Need to prepare a list of recommended STG regimens in the system of care.
This may be difficult for data collectors to record reliably. In practice, it may be
better to record each patient’s regimen for later evaluation.
Number of days' supply of medicine dispensed
11. The average number of days' supply of ARVs usually given to new patients.
12. The average number of days' supply of ARVs usually given to experienced
patients.
146