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

How to Investigate Adherence to Antiretroviral Treatment in Health Facilities: Adherence Indicators
solve unforeseen problems. It will also identify "natural leaders" who can assist the other data
collectors in case of difficulty.
Experience shows that during the pilot testing the rate of data collection is always very slow.
Data collectors should be reassured that with practice their rate will increase dramatically. So
study planners should not make calculation of the time required at each site based on this
exercise.
Ethics for Data Collectors
All data collectors should understand that any patient information they receive is
completely confidential. They should not under any circumstances divulge any of
that information to anyone else outside the survey. Depending on where the
survey is carried out, it may be necessary for the data collectors to sign a
confidentiality agreement.
It needs to also be understood that patients have no obligation to give exit interviews. Before
the interview begins the interviewer should communicate the purpose of the interview and
give an assurance of confidentiality. At that point, the patient needs to be asked for their
consent to continue with the interview. If the patient agrees, only at that point should the
interview begin.
To select the sample of patients for the retrospective sample from the attendance register, the
patient identifier form is used. For this only the patient identification number is recorded, not
the name. This will enable the pharmacy records to be found in the most anonymous way
possible.
Collecting Data
Remember to arrive at the same time as the clinic opens to set up before the main rush of the
day starts. After introducing the team members to the facility manager, the team needs to
quickly decide—
• How can they sample the retrospective records?
• Where they can sit to extract the data from the records?
• Where they can sit to do the exit interviews?
• How can they have the patients directed to that spot?
Sampling and Retrospective Data Extraction
The methods of retrospective sampling have been discussed before in chapter 4 and table 3,
but these need to be established and started immediately so that if selected records need to be
pulled, this can be done promptly so that the data extractors can start. It is important to
minimize any waiting time. The first step is therefore to work out how the sampling is
possible in that record-keeping system and start the process. This needs imagination and skill
on the part of the team leader.
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