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Speaking to the experts and patients: Recommendations for improving ART adherence
Abstract
This article reports on the fi ndings of a study that aimed to explore experts’ and patients’ opinions and recommendations regarding adherence to antiretroviral medication. This study was prompted firstly by the lack of existing local research on adherence to antiretroviral therapy (ART) and secondly by the importance of adherence, given the recent introduction of ART to the public health sector. Four experts and seven patients were interviewed. The experts had worked within the HIV/AIDS fi eld
for at least two years while the patients (chosen from public antiretroviral roll-out programmes) had been on ART for at least six months. These interviews were transcribed and analysed using thematic content analysis. This article focuses specifi cally on the recommendations for improving adherence that emerged from the experts' and patients' interviews. While the experts and patients generated two fairly distinct sets of recommendations (clearly informed by their different experiences and
knowledge), both groups emphasised the importance of the mediating effects of social support and the healthcare provider–patient relationship in adherence to ART medication
Opsomming: Gesprekke met kundiges en pasiënte: Aanbevelings ter verbetering van ART-nakoming. Hierdie artikel doen verslag oor die bevindinge van ’n studie wat kundiges en pasiënte se menings en
aanbevelings ten opsigte van die nakoming van antiretrovirale medikasievoorskrifte ondersoek het. Die studie is in die eerste plek uitgevoer na aanleiding van die gebrek aan bestaande plaaslike
navorsing oor die nakoming van antiretrovirale terapie (ART) en in die tweede plek na aanleiding van die belangrikheid van nakoming in die lig van die onlangse bekendstelling van ART in die openbaregesondheidsektor. Onderhoude is met vier kundiges en sewe pasiënte gevoer. Die kundiges het vir ten minste twee jaar binne die MIV/Vigs-omgewing gewerk en die pasiënte (wat uit die openbare antiretrovirale bekendstellingsprogramme gekies is) het ten minste ses maande van ART-terapie ondergaan. Die onderhoude is getranskribeer en met die gebruik van tematiese inhoudsanalise ontleed. Hierdie artikel fokus spesifi ek op die aanbevelings vir die verbetering van nakoming wat uit die onderhoude met die kundiges en die pasiënte gespruit het. Terwyl die kundiges en die pasiënte twee redelik uiteenlopende stelle aanbevelings gemaak het (wat duidelik deur hulle onderskeie ondervinding en kennis beïnvloed is), het altwee groepe beklemtoon dat die bemiddelende effek van maatskaplike ondersteuning en die verhouding tussen die pasiënt en die voorsiener van gesondheidsorg ’n belangrike rol speel in die nakoming van ART-medikasievoorskrifte.
