Usefulness of pharmacy dispensing records in the evaluation of adherence to antiretroviral therapy in Brazilian children and adolescents

Ernesto, Aline Santarem; Lemos, Renata Muller Banzato Pinto de; Huehara, Maria Ivone; Morcillo, André Moreno; Vilela, Maria Marluce dos Santos; Silva, Marcos Tadeu Nolasco da

doi:10.1016/j.bjid.2012.06.006

Cited by 28 publications

(9 citation statements)

References 36 publications

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“…Non-adherence to medicines has been associated with non-adherence to other disease management strategies e.g. keeping medical review appointments [ 22 ]. Patients that lack medicines administration schedules may have hectic lifestyles that lack the structure that is necessary to keep appointments or to establish a routine in which they take medicines.…”

Section: Discussionmentioning

confidence: 99%

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Kalyango¹,

Hall²,

Karamagi³

2014

Pan Afr Med J

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IntroductionProper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda.MethodsPatients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients.ResultsThe prevalence of missed appointments was 42% (95%CI = 35-49%). The factors associated with missed appointments were: monthly income ≤30US Dollars (OR = 2.56, CI = 1.25–5.26), affording less than half of prescribed drugs (OR = 3.92, CI = 1.64–9.40), not experiencing adverse events (OR = 2.66, CI = 1.26–5.61), not sure if treatment helps (OR = 2.84, CI = 1.047.77), not having a medicines administration schedule (OR = 6.77, CI = 2.11–21.68), and increasing number of drugs (OR = 0.72, CI = 0.53–0.98).ConclusionPatients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services.

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Section: Discussionmentioning

confidence: 99%

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Kalyango¹,

Hall²,

Karamagi³

2014

Pan Afr Med J

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“…Children’s adherence to ART was assessed using three measures: (1) caregiver three-day recall using a modified version of the self-report questionnaire developed by the Adult AIDS Clinical Trials Group (AACTG) (Chesney et al, 2000; Duong et al, 2001); (2) child three-day recall; and (3) pharmacy-based time-to-refill of ART (Ernesto et al, 2012; Grossberg, Zhang, & R., 2004). Self-reported adherence in a three-day recall period was analyzed as either “100% adherence” (no missed doses) in a three-day period or as “<100% adherence” (at least one missed dose) during that three-day period.…”

Section: Methodsmentioning

confidence: 99%

High prevalence of non-adherence to antiretroviral therapy among undisclosed HIV-infected children in Ghana

Nichols

Kyriakides²,

Antwi

et al. 2018

AIDS Care

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Adherence to antiretroviral therapy (ART) remains one of the greatest obstacles in pediatric HIV care. We sought to determine the prevalence of adherence to ART among undisclosed HIV-infected children and adolescents in Ghana. We analyzed baseline data from HIV-infected children and adolescents aged 7 to 18 years old enrolled in the SANKOFA Pediatric HIV disclosure intervention study in Ghana. Antiretroviral medication adherence was measured using caregiver 3-day recall; child 3-day recall; and pharmacy records for antiretroviral time-to-refill. Four hundred and twenty child-caregiver dyads were enrolled from January 2013 to June 2016. The median adherence (interquartile range), as measured by time-to-refill, was 93.2% (68.0% – 100.0%). However, only 47.5% of children had ≥95% adherence (“good adherence”) using time-to-refill data. Children of caregivers who had received secondary or higher level of education versus no school (aOR, 2.90, 95% Confidence Interval, CI 1.29 to 6.56), p = 0.010) or elementary education only (aOR, 2.20, CI, 1.24 to 3.88, p = 0.007) were more likely to have “good adherence” (≥95%). In this cohort of children unaware of their HIV positive status, median ART adherence rate was sub-optimal (by World Health Organization definition) while 38% had poor adherence (<85%).

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“…O cuidador precisará lidar com uma série de desafios para amparar o portador do HIV, sendo necessária uma boa comunicação entre pais e filhos, diminuindo o nível de estresse 16,17 . Como relatado, são os pais biológicos ou avós que assumem mais frequentemente esta função, porém, nem sempre de forma satisfatória, fazendo com que os registros de retirada de medicamentos na farmácia desempenhem função essencial na identificação de adesão insatisfatória, servindo de mecanismo de alerta tão logo a ausência na retirada de medicamentos ocorra 18,19 . Este alerta de má adesão ou abandono de tratamento, permite que sejam instituídas estratégias como a abordagem consentida, prevista pelo Ministério da Saúde, a partir da Nota Técnica nº 208/09, buscando evitar o agravamento da doença, procurando sanar ou minimizar os motivos da não adesão 20 .…”

Section: Discussionunclassified

Adesão a terapia antiretroviral de crianças e adolescentes vivendo com HIV

et al. 2017

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Usefulness of pharmacy dispensing records in the evaluation of adherence to antiretroviral therapy in Brazilian children and adolescents

Abstract: A high prevalence of HAART non-adherence was observed in the study population, and PDR was the most sensitive of the tested instruments. The instruments employed were complementary in the identification of non-adherence.

Cited by 28 publications

References 36 publications

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

High prevalence of non-adherence to antiretroviral therapy among undisclosed HIV-infected children in Ghana

Adesão a terapia antiretroviral de crianças e adolescentes vivendo com HIV

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