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APHA Scientific Session and Event Listing

Recorded presentation

Gavin Stewart Steel¹, Shabir Banoo¹, Mark Paterson², Heidi Van Rooyen³, Jude Nwokike¹, Mohan P. Joshi¹, Jean-Pierre Sallet¹, and Gillian Collett². (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, (3) Rustenburg Hospital Wellness Clinic, Cnr Bosch and Van Staden Street, Rustenburg, South Africa

Although the literature provides numerous adherence measurement instruments within the context of antiretroviral therapy (ART), no studies describe their use in routine care in a resource-constrained environment. The objective of this initiative was to develop and assess the feasibility of a simple nonelectronic medication adherence assessment tool that health care providers can use in busy ART clinics. Using such a tool can create a partnership of mutual problem-solving between ART providers and clients with adherence difficulties and can help identify appropriate interventions to address clients' adherence constraints.

Management Sciences for Health's Rational Pharmaceutical Management Plus Program developed a multi-method adherence assessment tool based on previously validated elements including self-report, visual analogue scale, pill identification test, and pill count. The self-report was based upon the Morisky Medication Adherence Scale with an additional question to check internal consistency. To assess the tool's feasibility, we analyzed the administration time, demographic data believed to impact administration, and the subjective evaluations of the administering pharmacists. This adherence tool was administered to clients presenting for routine follow-up ART care at two South African institutions.

The level of effort required to administer the tool was found acceptable for routine use in busy ART clinics. Internal consistency was sufficiently strong to recommend piloting the tool as part of South Africa's ART adherence measurement and support strategy. Additionally, this multi-method tool is simple and practical enough to use in routine ART adherence assessment and improvement programs in other resource-constrained countries.

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

• Recognize the different methodologies traditionally used to measure medication adherence and discuss their strengths and weaknesses.
• Describe potential adherence measurement techniques that would be useful to incorporate into a multi-method assessment tool.
• Articulate the procedure for assessing the adherence of a patient within a resource-constrained clinical setting.
• Describe issues related to antiretroviral therapy (ART) adherence and how an adherence assessment tool can help strengthen adherence improvement interventions.

Keywords: Adherence, Pharmacies

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation