Objectives: HIV case managers may be in a key position to assist clients with medication adherence; however, little is known about case managers’ adherence activities. This study examined the adherence counseling practices of North Carolina case managers working with clients living with HIV and identified barriers that may influence case managers’ ability to provide adherence counseling.
Design: A cover letter, self-administered questionnaire, and $5.00 were mailed in February 2000 to all case managers in North Carolina employed by agencies certified to provide HIV case management.
Results: Of the 119 case managers surveyed, 94 (85%) replied. Case managers are often placed in the position of addressing adherence issues: on average, just over half of their clients ask questions about medications. The adherence behaviors that case managers most commonly reported performing most or all of the time include praising adherent clients (84%), discussing the repercussions of nonadherence (74%), asking if clients have treatment questions or concerns (74%), and inquiring about side effects (65%). Less than a quarter routinely provide written medications instructions, assist clients to fill pillboxes or help clients plan dosing times. Case managers routinely assist clients to obtain services that can influence adherence such as transportation to medical appointments. Case managers reported difficulty obtaining funding for medications as a substantial barrier.
Conclusions: North Carolina HIV case managers appear to focus more on obtaining medication funding and monitoring medication use than providing basic dosing instructions. These activities can supplement the adherence practices of physicians and pharmacists to promote greater client adherence.
Learning Objectives: 1. Describe the adherence related activities of North Carolina HIV case managers. 2. Identify the barriers to providing adherence activities that are experienced by HIV case managers. 3. Articulate strategies to eliminate or reduce the barriers that restrict case managers' ability to assist clients with medication adherence.
Keywords: Adherence, Case Management
Awards: - Winner, - Honorable MentionPresenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.