| Title |
Strengthening adherence to Anti Retroviral Therapy (ART) monitoring and support: operation research to identify barriers and facilitators in Nepal
|
|---|---|
| Published in |
BMC Health Services Research, May 2015
|
| DOI | 10.1186/s12913-015-0846-8 |
| Pubmed ID | |
| Authors |
Kiran Bam, Rajesh M Rajbhandari, Dibesh B Karmacharya, Sameer M Dixit |
| Abstract |
Anti Retroviral Therapy (ART) is the cornerstone for comprehensive health sector response to Human Immunodeficiency Virus (HIV) treatment, care and support. Adherence of at least 95% is needed to keep HIV under control, as per World Health Organization (WHO) guidelines. This study was aimed at identifying the overall adherence level of, and barriers and facilitators to adherence for patients taking ART in different clinics in all five development regions of Nepal. A descriptive cross-sectional study was conducted among ART clients receiving free ART from Government of Nepal ART clinics. A total of 435 clients taking ART from 12 ART clinics in different regions of Nepal, aged 15 years and above were interviewed on one-and-one basis using questionnaires developed in reference to Adult AIDS Clinical Trial Group (AACTG) toolkit among them data from 404 were analyzed after cleaning. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) software where the P value of < 0.05 was accepted as being statistically significant. The overall adherence in the last month (missed less than 3 pills total) was 94.8% (383 out of 404). The main barrier to ART adherence was the fear of side effects (among 61.9% of the non adherent population) which included dizziness (18.1%) and headaches (15.4%). The standard wristwatch (39%) was found to be the most useful aid in enabling timely consumption of medication. Educational status (P = 0.018), drug using habits (P = 0.039) and the conducive environment at ART clinics (P = 0.004) were significantly associated with ART adherence. Improving better adherence may require a more holistic approach to treatment regimen and adapting it to patient daily routines. This study identifies issues such as pill count for assessing adherence, better access to health care facilities by clients, better access to medication, as well as improved nutritional support issues for better adherence by the population in the future. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Nepal | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 33% |
| Scientists | 1 | 33% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 60 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 17 | 28% |
| Student > Bachelor | 10 | 17% |
| Student > Postgraduate | 5 | 8% |
| Researcher | 4 | 7% |
| Student > Doctoral Student | 3 | 5% |
| Other | 9 | 15% |
| Unknown | 12 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 32% |
| Nursing and Health Professions | 11 | 18% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 5% |
| Immunology and Microbiology | 3 | 5% |
| Psychology | 3 | 5% |
| Other | 5 | 8% |
| Unknown | 16 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 November 2015.
All research outputs
#15,557,505
of 23,881,329 outputs
Outputs from BMC Health Services Research
#5,622
of 7,949 outputs
Outputs of similar age
#151,013
of 266,640 outputs
Outputs of similar age from BMC Health Services Research
#75
of 97 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,949 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
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We're also able to compare this research output to 97 others from the same source and published within six weeks on either side of this one. This one is in the 22nd percentile – i.e., 22% of its contemporaries scored the same or lower than it.