An investigation of the factors associated with default of scheduled drug pick-ups and clinic visits by patients on antiretroviral therapy at Murchison Hospital, Kwa Zulu Natal Province in South Africa
Date
2009-03
Authors
Zulu, Kahelo
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
The fact that patients on Highly Active Antiretroviral Therapy (HAART) default scheduled drug
pick-ups and clinic visits requires attention, because the long-term effect is non-adherence to
prescribed regimens and the development of drug resistance, as indicated in the report of the
Fourteenth Conference on Retroviruses and Opportunistic Infections held in November 2007 in
Los Angeles.
A cross-sectional survey and observational qualitative study was done to identify key factors
associated with the fact that patients on antiretroviral therapy fail to pick up drugs and keep
scheduled clinic appointments, with a view to suggesting intervention measures. The study
focused on Murchison Hospital in Ugu District, Kwa Zulu Natal Province.
Data were collected from patient records, telephonic interviews with patients, or patients’
caregivers, treatment supporters and family members of a patient who did not return for
follow-up at the clinic, as well as from face-to-face interviews with healthcare workers to
understand the reason for default. Observation checklists were used to collect data from
systems, structures and processes used in services provision. Thereafter data were analyzed
through the various stages of coding and writing up of notes and reported.
Of 638 defaulters identified, 205 were contactable, and only 95 patients were reached. The key
factors associated with default identified were death (49.5%) and logistics and cost (15%). Other
additional factors were travel and migration, religious beliefs, hospitalization, side effects, work
schedules and commitments, imprisonment and visiting private practices. Poor relationships
with healthcare workers, patients’ financial difficulties and termination of disability grants added
to the problem.
Description
Thesis (MPhil (Industrial Psychology))--University of Stellenbosch, 2009.
Keywords
Dissertations -- Industrial psychology, Theses -- Industrial psychology, Assignments -- Industrial psychology