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

How to Investigate Adherence to Antiretroviral Treatment in Health Facilities: Adherence Indicators
levels is increased. In the feasibility studies the national medians varied from 72 to 96
percent, but from a facility point of view the lowest was 15 percent. This means that only 15
percent of patients came on the day of their appointment.
Sometimes the appointment dates are not available in the pharmacy notes making the above
two indicators impossible to collect. Alternative attendance indicators are—
6. Percentage of all visits in the last six months made before the medicine supplied at the
previous visit have been consumed
7. Percentage of all visits in the last six months made within three days of when the
medicine supplied at the previous visit have been consumed
With the method of filling in the dispensing form and recording all dates of visits in the last
six months and numbers of days of pills dispensed, it is easy to automatically generate
another two indicators which are approximate to indicators 4 and 5 above and take into
account all the visits over the last six months rather than only looking at one. Alternative
attendance indicator six is—
Indicator 6 & 7. Percentage of all visits in the last six months made before the days of
medicine supplied at the previous visit have been consumed and
within three days of the drugs being consumed
Rationale
Source of data
Data collection
Computation
Comments
Rate of attendance before medicine is finished and within three days of the
medicines being finished are measures of treatment adherence and one
measure of program success in actively engaging patients
Pharmacy records
Based on exactly the same data as collected for indicators 2 and 3 above
which was based on the sample of 100 patients and used historical
dispensing data in pharmacy records. The date and days’ supply of all
ARVs dispensed during the index visit and during all subsequent visits for
this patient during the follow-up period chosen should be recorded.
Using the spreadsheet analysis tool the computation can be made for the
sample of patients
(Number of appointments attended on or before pills ran out/total number
of appointments sampled) × 100
(Number of appointments attended within three days of pills running out
/total number of appointments sampled) × 100
To calculate this indicator, the spreadsheet analysis tool is needed
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