Patient satisfaction and treatment adherence of stable HIV infected patients

De Jager, Gabi Ann (2016-03)

Thesis (MCur)--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT: South Africa had a 75% increase in access to Antiretroviral Treatment (ART) in 2011. Effective strategies to improve access and manage care need to be implemented into ART programs. ART adherence clubs is a new strategy that is being implemented in various parts of South Africa. The aim of the study was to investigate whether stable Human Immunodeficiency Virus (HIV) infected patients on ART who receive care in ART adherence clubs are more satisfied and more adherent to treatment than those who receive care in Primary Health Care (PHC) clinics. A quantitative cross-sectional study was done to compare patient satisfaction and treatment adherence in ART adherence clubs and PHC clinics in the Eden district within the Western Cape. The study sample included 320 participants (98 club and 222 clinic) from 13 PHC clinics (six with clubs and seven without clubs). One clinic was used for the pilot study and excluded from the data analysis. Stable HIV infected patients were recruited when they attended appointments for the club or clinic. Established questionnaires were used to measure patient satisfaction and self-reported treatment adherence. The questionnaires were completed by the research team for participants from September 2014 to March 2015 in Afrikaans, English and Xhosa. Descriptive and inferential statistics was done with STATISTICA and regression analysis in SPSS. The guideline for determining significance was 5% (p<0.05). The analyses showed that higher levels of satisfaction are predicted with club participants than with clinic participants. There was no significant difference between clinic and club participants with regards to estimated adherence (p>0.05). However, the odds of being adherent was more likely in participants that were satisfied (p<0.05, 95%, CI 0.252 to 0.882). ART adherence clubs therefore provide a service that patients may be more satisfied with, although they are not more adherent to treatment. PHC clinics with large patient volumes could use ART adherence clubs to reduce patient loads and to improve satisfaction of their stable HIV infected patients. Further research of patient experiences in ART adherence clubs may provide insight to the link between patient satisfaction and treatment adherence.

AFRIKAANSE OPSOMMING: Suid Afrika het ‘n 75% styging gehad in die toegang tot Antiretrovirale Terapie (ART) in 2011. Effektiewe strategieë om die toeganklikheid en bestuur daarvan te verbeter in ART programme moet geïmplementeer word. ART nakomingsklubs is ’n nuwe strategie wat in verskeie dele van Suid-Afrika geïmplementeer word. Die doel van die studie was om te ondersoek of stabiele Menslike Immuniteitsgebrek Virus (MIV) geïnfekteerde pasiënte op ART wat hul sorg by ART nakomingsklubs ontvang, meer tevrede is en meer getrou is met die gebruik van hul terapieteenoor die pasiënte wat hul sorg by Primêre Gesondheidsorg (PGS) klinieke ontvang. ʼn Kwantitatiewe deursnee studie was gedoen om pasiënt tevredenheid en behandeling nakoming te vergelyk in ART nakomings klubs en PGS klinieke in die Wes Kaapse Eden distrik. Die studie het 320 (98 klub en 222 kliniek) pasiënte ingesluit van 13 PGS klinieke (ses met klubs en sewe sonder klubs). Een kliniek was as die loodsstudie gebruik en uitgesluit uit die data analise. Stabiele MIV pasiënte was genader en ingesluit soos per bywoning by kliniek of klub. Vasgestelde vraelyste was gebruik om pasiënt tevredenheid asook subjektiewe behandeling nakoming te meet. Die vraelyste is voltooi deur lede van die navorsingsspan vanaf September 2014 tot Maart 2015 in Afrikaans, Engels en Xhosa. Beskrywende en afleibare statistieke was gedoen deur STATISTICA en regressie analise in SPSS. Die maatstaf om beduidendheid te toon was 5% (p<0.05). Die analise het getoon dat hoër vlakke van tevredenheid verwag kan word onder die klub pasiënte in vergelyking met die kliniek pasiënte. Daar was geen beduidende verskil tussen die klub en kliniek pasiënte ten opsigte van behandeling nakoming nie (p<0.05). Die kans om meer getrou te wees was wel hoër in pasiënte wat meer tevrede was (p<0.05, 95%, Cl 0.252 tot 0.882). ART nakomingsklubs lewer dus ʼn diens waarmee pasiënte meer tevrede is, alhoewel hulle nie meer getrou is tot behandeling is nie. PGS klinieke met hoë pasiënt volumes kan gebruik maak van ART nakomings klubs om die pasiënt lading te verminder en stabiele MIV geïnfekteerde pasiënte se tevredenheid te verbeter. Verdere navorsing van pasiënte in ART nakomings klubs kan verdere insae lewer oor die verhouding tussen pasiënt tevredenheid en terapie nakoming.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/98600
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