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

How to Investigate Adherence to Antiretroviral Treatment in Health Facilities: Adherence Indicators
Exit Interviews
The purpose of this form is to ask for self report on adherence, as well as check how long
patients spent at the clinic, how long it took to travel to the clinic, how many of their
prescribed ARVs and other drugs were actually dispensed, whether the medicines are
correctly labelled, whether the patient has experienced any adverse drug events in the last
month, and whether they know how to take their medicine correctly.
All questions will need to be asked in appropriate local languages. The uniform way of
asking each question in the appropriate language needs to be agreed upon and written down.
This can be done at the time of data collection training
The proposed patient indicators can also be used to assess adherence among paediatric
patients. If the patient is a child who has been brought to the clinic by a caregiver, then there
are two screening questions to ask the caregiver to see whether the child would be eligible for
the survey. If the caregiver is not the one who usually gives the child medicine, then that
child should not be included. (Patient Exit Interview Form)
It is desirable to conduct at least 30 exit interviews at each facility. If there are not 30
patients, then try to interview all the patients that visited that day. So it is important to visit on
a day when patients are expected. The patients you want to interview are those on ART, but
not those who started ART the same day of data collection.
The interview should be done sitting down in a comfortable spot. It will be most helpful to
find a good place and ask the pharmacy dispenser to ask the relevant patients to go there for
interview. The place should be near the pharmacy as this is the last place the patient usually
visits before leaving the clinic.
It is important to be pleasant and polite. You should speak in a language well known to the
patient, and not be officious, dress in a white coat, or speak with technical words. You must
put the patient at their ease if you wish to get real information. The main point is to build a
trust so that when you get to the final questions on whether they have missed any doses in the
last three days they will give you an honest answer.
The patient is under no obligation to speak to you, so it is important to introduce yourself
with the important points—
• You are working with the Ministry of Health to try and help to improve services for
people taking ARVs
• It will only take a few minutes
• It is confidential; no harm or change will happen to the patient as a result of partaking
• The patient may withdraw at any time
A typical introduction may go—
“Good morning. My name is……… and I’m working with the Ministry of Health to
try and help to improve services for ARVs in the country. I would like to speak to you
for a few minutes about your experience in the clinic today and the medicines you are
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