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APHA Scientific Session and Event Listing

Gavin Stewart Steel¹, Mark Paterson², and Jean-Pierre Sallet¹. (1) Rational Pharmaceutical Management Plus Program, Management Sciences for Health, PO Box 15053, Beacon Bay, East London, 5205, South Africa, 27 12 43 7483635, gsteel@msh.org, (2) Cecilia Makiwane Hospital, 00, Mdantsane, South Africa

Cecilia Makiwane Hospital (CMH), in Eastern Cape Province, enrolled over 800 patients in the first year of their ART program. Once a patient has stabilized, frequent trips to the hospital just to pick up medicines can cost R120 (USD19) for transportation. This strains patients' already low income and may introduct an adherence barrier.

The Rational Pharmaceutical Management Plus Program created RxSolution—a computerized tool used to shift ART medicine dispensing to local health care facilities. When CMH refers patients, pharmacy staff records patient details into the RxSolution database, then prescriptions are organized by referral clinic; packaged with appropriate information, including a patient accountability checklist; and delivered to local clinics. Clinic nurses dispense medications and review patients' treatment progress. The clinic returns progress reports and uncollected medication to CMH, where staff monitors patient adherence at the local clinics.

In operation over six months, RxSolution has made it possible for HIV/AIDS patients to access their medicines at local health facilities rather than spend time and money to travel to CMH, while still allowing for appropriate treatment oversight. The system has worked so well for ART patients that CMH expanded it to include now over 1000 patients needing chronic treatment for mental health.

Referring patients to community health facilities and maintaining the standard of care is challenging, but treatment adherence relies on reducing a patient's burden. Innovative approaches to increasing adherence in ART patients can be successfully expanded to include other chronic conditions, thereby strengthening the delivery of quality health care to everyone.

Learning Objectives: At the conclusion of the session, participants will be able to

• recognize constraints to treatment adherence in resource-limited settings—especially for chronic health conditions, like HIV/AIDS;
• describe how a computerized pharmacy tool makes it possible to shift treatment to local clinics while maintaining a standard of care;
• discuss how an intervention to improve antiretroviral therapy (ART) adherence was successfully applied to another patient population needing chronic care.

Keywords: Pharmacies, Access to Health Care

Presenting author's disclosure statement:

Not Answered