How to investigate levels of Adherence to antiretroviral ... - INRUD
How to investigate levels of Adherence to antiretroviral ... - INRUD
How to investigate levels of Adherence to antiretroviral ... - INRUD
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<strong>How</strong> <strong>to</strong> Investigate <strong>Adherence</strong> <strong>to</strong> Antiretroviral Treatment:<br />
An Indica<strong>to</strong>r-Based Approach<br />
Note:<br />
If the appointment was on the 11th and they came on the 14th, the answer would be Yes. If<br />
they attended on the 15th, the answer would be No.<br />
The system will validate that the data in columns BX, BY, BZ and CA <strong>to</strong> ensure that it is<br />
consistent.<br />
Filling in the exit interview forms<br />
The purposes <strong>of</strong> this form are <strong>to</strong> ask for self-report on adherence, as well as check how long<br />
patients spent at the clinic, how long it <strong>to</strong>ok <strong>to</strong> travel <strong>to</strong> the clinic, how many <strong>of</strong> their<br />
prescribed ARVs and other drugs were actually dispensed, whether the medicines are<br />
correctly labelled, whether the patient has experienced any adverse drug events in the last<br />
month, and whether they know how <strong>to</strong> take their medicine correctly.<br />
All questions will need <strong>to</strong> be asked in appropriate local languages. The uniform way <strong>of</strong><br />
asking each question in the appropriate language needs <strong>to</strong> be agreed upon and written<br />
down. This can be done at the time <strong>of</strong> data collection training.<br />
The proposed patient indica<strong>to</strong>rs can also be used <strong>to</strong> assess adherence among paediatric<br />
patients. If the patient is a child who has been brought <strong>to</strong> the clinic by a caregiver, then there<br />
are two screening questions <strong>to</strong> ask the caregiver <strong>to</strong> see whether the child would be eligible<br />
for the survey. If the caregiver is not the one who usually gives the child medicine, then that<br />
child should not be included. (Patient exit interview form).<br />
It is desirable <strong>to</strong> conduct at least 30 exit interviews at each facility. If there are not 30<br />
patients, then try <strong>to</strong> interview all the patients that visited that day. It is important <strong>to</strong> visit on<br />
a day when patients are expected. The patients you want <strong>to</strong> interview are those on ART, but<br />
not those who started ART the same day <strong>of</strong> data collection.<br />
The interview should be done sitting down in a comfortable spot. It will be most helpful <strong>to</strong><br />
find a good place and ask the pharmacy dispenser <strong>to</strong> ask the relevant patients <strong>to</strong> go there for<br />
interview. The place should be near the pharmacy as this is the last place the patient usually<br />
visits before leaving the clinic.<br />
It is important <strong>to</strong> be pleasant and polite. You should speak in a language well known <strong>to</strong> the<br />
patient, and not be <strong>of</strong>ficious, or dress in a white coat, or speak with technical words. You<br />
must put the patient at their ease if you wish <strong>to</strong> get real information. The main point is <strong>to</strong><br />
build a trust so that when you get <strong>to</strong> the final questions on whether they have missed any<br />
doses in the last three days they will give you an honest answer.<br />
The patient is under no obligation <strong>to</strong> speak <strong>to</strong> you, so you should introduce yourself with<br />
the important points:<br />
You are working with the Ministry <strong>of</strong> Health <strong>to</strong> try and help <strong>to</strong> improve services for<br />
people taking ARVs.<br />
It will only take a few minutes.<br />
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