Measuring adherence to antiretroviral therapy in northern Tanzania: feasibility and acceptability of the Medication Event Monitoring System
| Autor: | Declare Mushi, André J. A. M. van der Ven, Jossy van den Boogaard, Harm J. Hospers, Ramsey A Lyimo, Elizabeth Msoka, Marijn de Bruin |
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| Přispěvatelé: | Work and Social Psychology, RS: FPN WSP II |
| Jazyk: | angličtina |
| Předmět: |
Program evaluation
Adult Male medicine.medical_specialty malawi Population Alternative medicine Communication Science HIV Infections WASS challenges Tanzania Interviews as Topic Epidemiology medicine Humans education Drug Packaging hiv patients education.field_of_study biology Communicatiewetenschap nonadherence business.industry Public health lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Middle Aged biology.organism_classification Anti-Retroviral Agents Pill Family medicine embryonic structures Physical therapy HIV-1 Feasibility Studies Patient Compliance Female progression Biostatistics Electronics business Research Article |
| Zdroj: | BMC Public Health 11 (2011) BMC Public Health, 11 BMC Public Health, Vol 11, Iss 1, p 92 (2011) BMC Public Health BMC Public Health, 11:92. BioMed Central Ltd |
| ISSN: | 1471-2458 |
| DOI: | 10.1186/1471-2458-11-92 |
| Popis: | Background An often-used tool to measure adherence to antiretroviral therapy (ART) is the Medication Event Monitoring System (MEMS), an electronic pill-cap that registers date and time of pill-bottle openings. Despite its strengths, MEMS-data can be compromised by inaccurate use and acceptability problems due to its design. These barriers remain, however, to be investigated in resource-limited settings. We evaluated the feasibility and acceptability of using MEMS-caps to monitor adherence among HIV-infected patients attending a rural clinic in Tanzania's Kilimanjaro Region. Methods Eligible patients were approached and asked to use the MEMS-caps for three consecutive months. Thereafter, qualitative, in-depth interviews about the use of MEMS were conducted with the patients. MEMS-data were used to corroborate the interview results. Results Twenty-three of the 24 patients approached agreed to participate. Apart from MEMS-use on travel occasions, patients reported no barriers regarding MEMS-use. Unexpectedly, the MEMS-bottle design reduced the patients' fear for HIV-status disclosure. Patients indicated that having their behavior monitored motivated them to adhere better. MEMS-data showed that most patients had high levels of adherence and there were no bottle-openings that could not be accounted for by medication intake. Non-adherence in the days prior to clinic visits was common and due to the clinic dispensing too few pills. Conclusion MEMS-bottle use was readily accepted by patients. Although the MEMS-bottle was used accurately by most patients, patients need to be more explicitly instructed to continue MEMS-use when travelling. Even HIV-clinics with sufficient staff and free medication may impose structural adherence barriers by supplying an insufficient amount of pills. |
| Databáze: | OpenAIRE |
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