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

Appendix 6
Complementary indicators of determinants of adherence
Rationale
Source of data
Data collection
Computation
Comments
The number of days of ARVs dispensed dictates how often the patient has to
return to the clinic. The more frequent, the more time is sacrificed to
treatment, but also the more contact the patient has with the clinic. Both of
these factors may affect adherence.
Facility Interview and Retrospective data form.
While doing the facility interview ask whether the clinic has a normal protocol
for the numbers of days of ARVs dispensed to new and to experienced
patients. Also observe the most frequent numbers when filling in the
retrospective data form.
New Patients—The stated average number of days of ARVs dispensed to new
patients.
Experienced Patients—The stated average number of days of ARVs dispensed
to experienced patients.
This information can be checked while filling in the retrospective dispensing
data form. If there is a disagreement in the results, what is found on the
dispensing data form will be more accurate.
Facility services and contact with the community
13. The percentage of facilities that provide food for patients.
14. The percentage of facilities that have a formal system for linking patients with
other persons living with HIV as support partners.
15. The percentage of facilities that have connection with the local community, such as
churches or other organizations.
Rationale
Source of data
Data collection
Computation
Comments
When poor patients start ART, their appetite improves and they start to put on
weight. The increased appetite represents increased cost. This can be
facilitated by the programme providing food to the patients during their first
months of treatment. With chronic diseases by far the majority of the patient’s
time is spent in the community rather than in the facility. Therefore community
support and community linkages are key to helping the patient adhere.
Facility interview.
While doing the facility interview ask whether the clinic has a policy for giving
food to patients; whether they have a formal system for linking patients with
other persons living with HIV as support partners; and whether they have
connection with the local community, such as churches or other organizations.
Food—Does the facility provide food to patients?
Linking patients with other persons living with HIV as support partners—Does
the facility have a formal linking system?
Linkage with the community—Does the facility have active links?
This information can be checked for completeness by asking patients in the
exit interviews.
3. Complementary demographic indicators
1. Tuberculosis status—Percentage of patients with TB comorbidity.
2. WHO disease stage at initiation of ARVs: Percentage of patients diagnosed as stage I,
II, III and IV at initiation.
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