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Methodological Aspects of the Study :

Methodological Aspects of the Study : Baseline Data and Predictors of Adherence in Patients on Antiretroviral Therapy in Maun General Hospital [MGH], Maun, Botswana. Background Info. ACHAP. National antiretroviral program

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Methodological Aspects of the Study :

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  1. Methodological Aspects of the Study: Baseline Data and Predictors of Adherence in Patients on Antiretroviral Therapy in Maun General Hospital [MGH], Maun, Botswana

  2. Background Info • ACHAP. National antiretroviral program • No experience/Baseline data on Adherence [Weiser et al pre roll-out study] • Pre-treatment Antiretroviral Adherence Counseling, PADAC as part of protocol • Integrated Patient Management Systems, IPMS. • Our study found 83% average adherence

  3. Measuring Adherence 1 • Pill Count Method. -The use of Adherent days/Month -The use of Zero tolerance to Non-adherence -The place of overage & extra pills in measurement -MGH methodology -How to calculate average adherence for HAART

  4. 7 days recalls questionnaire • -Subjective • -Standard questions memorized, used with probes [hybrid of 7 days recall & Provider assessment] • -Values assigned in percent based on provider estimation • -Found useful even in experienced patients to clarify suspected non-adherent days Measuring Adherence 2

  5. Measuring Adherence 3 • Pills Identification tests -Challenges include how you value PIT patient performance -Useful at the early days of therapy • Monthly Pill Calendar -Highly subject to fabrications -Also utilizes zero tolerance to non-adherence

  6. Challenges • Subjective nature of adherence reports • Non-electronic methods and their susceptibility to fabrications • Grading of adherence scores particularly with 7 days recall and provider assessments • Even conflicting reporting of observations from Pill counts • Time consuming

  7. Conclusions • Simple and non-electronic adherence measurement methods should be standardized as they are crucial in developing countries • There is a need to evaluate the efficacy of formal institution-based comprehensive adherence education and counseling programs and other interventions • Healthcare facilities should develop adherence monitoring and measurement plans that is ongoing and multidisciplinary • MGH Manual and methodology could do with experiences from other treatment centers.

  8. ADHERENCE MONITORING • -A Manual/SOP for Healthcare Providers for the Provision of Adherence Support for Individuals on Antiretroviral Therapy Prepare By Jude Nwokike [B.Pharm.,MSc.Pharmacology] Principal Pharmacist 11, Maun General Hospital, Maun. Rep. of Botswana.

  9. Thank You!

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