Antiretroviral drug adherence : what happens when patients are hospitalized to medical wards and level one wards in Dr. George Mukhari hospital, Pretoria, and they are on Highly Active Antiretroviral Therapy [HAART]

Nkosi, Thandi Hazel (2010-03)

Thesis (MPhil)--Stellenbosch University, 2010.

Thesis

ENGLISH ABSTRACT: Purpose of the study The main purpose of the study was to investigate the antiretroviral drug adherence of patients on government HAART regimen while being hospitalized at Dr. George Mukhari hospital in medical wards and level one ward. Ensuring high levels of adherence to antiretroviral treatment is a priority in managing patients with AIDS. Research Design Qualitative and quantitative data was collected prospectively. Data was collected through interviewing patients and registered nurses using structured questionnaires. Doctors’ clinical notes from the participant’s (patients) files were audited to understand the real gaps in failing to support the patients with adherence to their treatment. Findings In investigating the antiretroviral treatment drug adherence of hospitalized patients, two indicators were used:  The percentage of patient’s drug adherence level.  The level of support that is given by registered nurses and doctors to support the patients in maintaining their adherence to treatment while admitted. The research findings from the 25 participants revealed that 28% of patients had >95% adherence level and 72% of patients had <95% adherence level. The level of support from the doctors and registered nurses was poor, there was no commitment. These findings suggest that further studies are needed to improve the adherence level of patients on antiretroviral treatment. Conclusions Adherence to antiretroviral treatment is a powerful predictor of survival for individual living with HIV and AIDS. Factors that contributed to non-adherence should be attended to without delay.

AFRIKAANSE OPSOMMING: Doel van die studie Die doel van die studie was om te bapaal of pasiënte voldoen aan die regering se “HAART-regime” wat Anti-retrovilare (ARV’s) ontvang, gehospitaliseerd te Dr. George Mukhari hospital. Die voldoening aan die toediening van ARV- behandeling is prioriteit in die behandeling en bevording van pasiënte met VIGS. Studie Ontwerp Kwalitatiewe en kwantitatiewe data was prospektief ingesamel. Data was ingesamel deur onderhoudvoering met pasiënte en geregistreerde susters, deur gebruik te maak van gestruktureerde vraelyste. Kliniese notas gemaak deur dokters in die betrokke pasiënt-leers is ook bestudeer om die probleemareas vas te stel, waar toediening van ARV- behandeling nie voldoende plaasgevind het nie. Bevindinge Twee indikatore is gebruik om te bestudeer of voldoende toediening van ARV-behandeling plaasvind.  Die persentasie van pasiënte wat wel voldoen aan korrekte ARV–behandeling.  Die vlak van ondersteuning ontvang deur geregistreerde susters en mediese dokters in die toediening van ARV- behandeling. Die navorsingsresultale toon die volgende van die studiegroep (=25):  28% : >95% voldoende toediening van ARV- behandeling.  72% : <95% voldoende toediening van ARV- behandeling. Die vlak van ondersteuning ontvang deur susters en mediese dokters was swak. Die bogenoemde bevindinge toon dat verdere studies nodig is om die vlak van voldoende toediening van ARV– behandeling te bevorder en te verbeter. Gevolgtrekking Voldoende toediening van ARV–behendeling is ‘n sterk voorspeller vir die oorlewing van individue met MIV en VIGS. Faktore wat bydrae tot onvoldoende toediening van ARV–behandeling moet aangespreek word.

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