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

[摘要] The fact that patients on Highly Active Antiretroviral Therapy (HAART) default scheduled drugpick-ups and clinic visits requires attention, because the long-term effect is non-adherence toprescribed regimens and the development of drug resistance, as indicated in the report of theFourteenth Conference on Retroviruses and Opportunistic Infections held in November 2007 inLos Angeles.A cross-sectional survey and observational qualitative study was done to identify key factorsassociated with the fact that patients on antiretroviral therapy fail to pick up drugs and keepscheduled clinic appointments, with a view to suggesting intervention measures. The studyfocused 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 forfollow-up at the clinic, as well as from face-to-face interviews with healthcare workers tounderstand the reason for default. Observation checklists were used to collect data fromsystems, structures and processes used in services provision. Thereafter data were analyzedthrough 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 keyfactors associated with default identified were death (49.5%) and logistics and cost (15%). Otheradditional factors were travel and migration, religious beliefs, hospitalization, side effects, workschedules and commitments, imprisonment and visiting private practices. Poor relationshipswith healthcare workers, patients' financial difficulties and termination of disability grants addedto the problem.

[发布机构] Stellenbosch University