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ISRN AIDS  2013 

Missed Doses and Missed Appointments: Adherence to ART among Adult Patients in Uganda

DOI: 10.1155/2013/270914

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Abstract:

Background. Missed doses and appointments are predictors of incomplete adherence among patients on ART. The AIDSRelief model emphasizes treatment preparation and continuous treatment support for ART patients including community followup. Methods. In August 2008, a survey was conducted among patients on antiretroviral therapy (ART) (interquartile range for duration of ART?=?29–46 months, median?=?33 months, , age >16 years), in 15 health facilities in Uganda. Missed doses and appointments among adult patients on ART and the factors most associated with these were identified. Reasons for missed doses were also explored. Results. The survey revealed that 97% of the patients had not missed their doses in the last week while 93% had not missed their appointments in the last three months. For those who had missed their doses, the most common reasons were travel (48%) and forgetfulness (28%). There was a significant association between missing doses and missing appointments ( ) and between alcohol use and missed doses ( ). Conclusions. The level of adherence to medication and clinic appointments for patients on ART in the study population was very high. It is important to strengthen adherence strategies at both facility and community levels to assist patients that are likely to miss their doses or appointments. 1. Background Uganda has more than 1.2 million people living with HIV infection and in 2010 more than 120,000 got infected with HIV [1]. Although there are various efforts to scale up AIDS treatment, many HIV-infected people are unable to access treatment and the increasing new HIV infections still exceed the government’s capacity to provide treatment [2]. While attempts are being made to reduce new infections and to scale up antiretroviral therapy (ART), it is equally important to improve adherence to regimens among the few who are already accessing ART for successful treatment [3]. ART delays progression to AIDS and death, hence, improved the quality of life for people living with HIV [4, 5]. Maintaining good adherence has been found to be difficult to achieve and sustained by both patients and health care providers [6, 7]. A major concern with the use of ART is the emergence of viral resistance, which is mainly due to insufficient compliance [8]. Different tools have been used to determine ART adherence rates and on average the rate of adherence to ART is about 70% [9]. A meta-analysis found adherence rates for African patients to be approximately 77% [10]. A study by Oyugi et al., that assessed correspondence between multiple measures of adherence

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