• Login
    View Item 
    •   Home
    • 1 Published Research and Commentary
    • HIV/AIDS
    • View Item
    •   Home
    • 1 Published Research and Commentary
    • HIV/AIDS
    • View Item
    Apr 10, 2021
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of MSFTitleAuthorsSubjectsPublisherJournalThis CollectionTitleAuthorsSubjectsPublisherJournal

    'Only twice a year': a qualitative exploration of 6-month antiretroviral treatment refills in adherence clubs for people living with HIV in Khayelitsha, South Africa

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    Keen et al 2020 Only twice a ...
    Size:
    335.7Kb
    Format:
    PDF
    Download
    Authors
    Keene, CM
    Zokufa, N
    Venables, EC
    Wilkinson, L
    Hoffman, R
    Cassidy, T
    Snyman, L
    Grimsrud, A
    Voget, J
    von der Heyden, E
    Zide-Ndzungu, S
    Bhardwaj, V
    Isaakidis, P
    Show allShow less
    Issue Date
    2020-07-08
    Submitted date
    2020-07-23
    
    Metadata
    Show full item record
    Journal
    BMJ Open
    Abstract
    Objective Longer intervals between routine clinic visits and medication refills are part of patient-centred, differentiated service delivery (DSD). They have been shown to improve patient outcomes as well as optimise health services—vital as ‘universal test-and-treat’ targets increase numbers of HIV patients on antiretroviral treatment (ART). This qualitative study explored patient, healthcare worker and key informant experiences and perceptions of extending ART refills to 6 months in adherence clubs in Khayelitsha, South Africa. Design and setting In-depth interviews were conducted in isiXhosa with purposively selected patients and in English with healthcare workers and key informants. All transcripts were audio-recorded, transcribed and translated to English, manually coded and thematically analysed. The participants had been involved in a randomised controlled trial evaluating multi-month ART dispensing in adherence clubs, comparing 6-month and 2-month refills. Participants Twenty-three patients, seven healthcare workers and six key informants. Results Patients found that 6-month refills increased convenience and reduced unintended disclosure. Contrary to key informant concerns about patients’ responsibility to manage larger quantities of ART, patients receiving 6-month refills were highly motivated and did not face challenges transporting, storing or adhering to treatment. All participant groups suggested that strict eligibility criteria were necessary for patients to realise the benefits of extended dispensing intervals. Six-month refills were felt to increase health system efficiency, but there were concerns about whether the existing drug supply system could adapt to 6-month refills on a larger scale. Conclusions Patients, healthcare workers and key informants found 6-month refills within adherence clubs acceptable and beneficial, but concerns were raised about the reliability of the supply chain to manage extended multi-month dispensing. Stepwise, slow expansion could avoid overstressing supply and allow time for the health system to adapt, permitting 6-month ART refills to enhance current DSD options to be more efficient and patient-centred within current health system constraints.
    Publisher
    BMJ
    URI
    http://hdl.handle.net/10144/619703
    DOI
    10.1136/bmjopen-2020-037545
    PubMed ID
    32641338
    Type
    Article
    Language
    en
    EISSN
    2044-6055
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2020-037545
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

    Related articles

    • Patient experiences of ART adherence clubs in Khayelitsha and Gugulethu, Cape Town, South Africa: A qualitative study.
    • Authors: Venables E, Towriss C, Rini Z, Nxiba X, Cassidy T, Tutu S, Grimsrud A, Myer L, Wilkinson L
    • Issue date: 2019
    • Twenty-four-month outcomes from a cluster-randomized controlled trial of extending antiretroviral therapy refills in ART adherence clubs.
    • Authors: Cassidy T, Grimsrud A, Keene C, Lebelo K, Hayes H, Orrell C, Zokufa N, Mutseyekwa T, Voget J, Gerstenhaber R, Wilkinson L
    • Issue date: 2020 Dec
    • A cluster randomized controlled trial of extending ART refill intervals to six-monthly for anti-retroviral adherence clubs.
    • Authors: Wilkinson L, Grimsrud A, Cassidy T, Orrell C, Voget J, Hayes H, Keene C, Steele SJ, Gerstenhaber R
    • Issue date: 2019 Jul 30
    • Experiences of HIV-positive postpartum women and health workers involved with community-based antiretroviral therapy adherence clubs in Cape Town, South Africa.
    • Authors: Trafford Z, Gomba Y, Colvin CJ, Iyun VO, Phillips TK, Brittain K, Myer L, Abrams EJ, Zerbe A
    • Issue date: 2018 Jul 31
    • The effectiveness and cost-effectiveness of 3- vs. 6-monthly dispensing of antiretroviral treatment (ART) for stable HIV patients in community ART-refill groups in Zimbabwe: study protocol for a pragmatic, cluster-randomized trial.
    • Authors: Fatti G, Ngorima-Mabhena N, Chirowa F, Chirwa B, Takarinda K, Tafuma TA, Mahachi N, Chikodzore R, Nyadundu S, Ajayi CA, Mutasa-Apollo T, Mugurungi O, Mothibi E, Hoffman RM, Grimwood A
    • Issue date: 2018 Jan 29
    DSpace software (copyright © 2002 - 2021)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.