How to investigate Adherence to Antiretroviral Treatment ... - INRUD

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How to investigate Adherence to Antiretroviral Treatment in Health Facilities: Adherence Indicators 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—Percent 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 Patient clinical records are examined to determine if current treatment is consistent with national STG for selection and dosing of ARVs Computation (Number of patients whose last treatment was consistent with STGs/number of patients records examined) × 100 Comments 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. 110
Appendix 5. Complementary Indicators of Determinants of Adherence 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 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 towards 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 111
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How to investigate Adherence to Ant
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ACKNOWLEDGEMENTS This manual has be
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ACRONYMS AIDS ART ARV HIV IAA IHCAR
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CONTENTS Acknowledgements .........
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INTRODUCTION Collecting data on adh
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CHAPTER 1. OVERVIEW OF MANUAL The 2
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Chapter 1. Overview of Manual Table
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CHAPTER 2. CORE INDICATORS OF ADHER
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Chapter 2. Core Indicators of Adher
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Chapter 2. Core Indicators of Adher
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CHAPTER 3. INDICATORS FOR POSSIBLE
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Chapter 3. Indicators for possible
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CHAPTER 4. SURVEY DESIGN Sampling F
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Chapter 4. Survey Design Figure 1.
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CHAPTER 5. DATA COLLECTION TOOLS AN
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Chapter 5. Data Collection Tools an
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CHAPTER 6. PLANNING AND FIELD METHO
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Chapter 6. Planning and Field Metho
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