Browsing by Author "Marais, Melanie"

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    A descriptive study to evaluate the effect of guidelines used by counsellors to improve adherence to antiretroviral therapy in the private sector
    (University of the Western Cape, 2006) Marais, Melanie; Nikodem, Cheryl
    INTRODUCTION: To achieve a virological outcome to antiretroviral therapy, a high adherence level is required. OBJECTIVE: To implement and evaluate guidelines that will be used by treatment support counsellors in an attempt to increase client adherence to antiretroviral treatment. METHODS: A quasi - experimental comparative study was used to assess whether a structured treatment support guidelines can improve client adherence to antiretroviral therapy. The treatment outcome of two groups was compared: one group received the adherence guidelines and the other group was a historical group where no adherence guidelines were applied. The main outcome measure was whether adherence guidelines improved adherence to ART. PARTICIPANTS: Forty clients were exposed to the adherence guidelines and 34 were not. SETTING: Clients that subscribe to Aids for Aids . Intervention: A structured guideline used by counsellors with regular contact. RESULTS: Specific guidelines used by counsellors to improve adherence to antiretroviral therapy has shown that significantly more clients in the intervention group had their CD4 blood tests done after six months and adhered to regularly claim their medications. In addition were there more clients in the intervention group who had viral loads of less than 400 copies I ml after six months. CONCLUSION: Specific counselling using effective guidelines improve adherence to antiretroviral treatment.
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    A descriptive study to evaluate the effect of guidelines used by counsellors to improve adherence to antiretroviral therapy in the private sector
    (University of the Western Cape, 2006) Marais, Melanie; Nikodem, C; Dept. of Nursing; Faculty of Community and Health Sciences
    A problem was identified at Aid for AIDS (AfA) whereby some doctors requested a change in treatment within less than a year after their patients started antiretroviral therapy. The requests were normally based on treatment failure. It appears that in most cases where the desired treatment outcome is not achieved is due to poor adherence to therapy. AfA is a HIV / AIDS disease management company offering access to antiretroviral therapy (ART), prevention of opportunistic infections, treatment and blood results monitoring, treatment support through adherence coordinators and expert clinical support and advice to healthcare providers. They monitor treatment adherence through claims history, CD4 and viral load (VL) results as well as telephonic contact with the client. Factors that could contribute to poor adherence are side - effects, barriers e.g. work environment, non - disclosure, lifestyle, lack of client commitment, limited contact between the client and treatment support counsellor, limited funds, stigmatisation and a lack of clear adherence guidelines to improve treatment outcome. Method: A comparative study was done to assess the impact of an intervention to improve patient adherence to ART. The researcher postulates that by the implementation of guidelines to counsellors, client adherence to therapy would increase. A comparative study was used to assess whether structured guidelines can improve client adherence to therapy. Results: The results have proven that guidelines used by treatment support counsellors does improve adherence to ART. Recommendations: It is recommended that treatment support counsellors, to improve their clients’ adherence to ART, should apply adherence guidelines.