AEGiS-15IAC: How to achieve >95% adherence for children on antiretroviral therapy (ART) in a resource limited country.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

How to achieve >95% adherence for children on antiretroviral therapy (ART) in a resource limited country.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1324)

Hansudewechakul DR, Plangraun MS, Yodsuwan MS
ChiangRai regional Hospital, ChiangRai, Thailand

ISSUE: Adherence in ART is essential to maximize the benefits of treatment and minimize possibilities of resistance mutations. However ensuring a high level of adherence is very difficult, especially in cases of children on ART. This paper will provide an example of lessons learned through experience of a regional hospital team. Through a team of medical staff, social workers, patient's networks and caregivers working together,comprehensive care is provided to promote adherence for HIV-infected children.

DESCRIPTION: Before starting ART the caregivers and children are counseled on the need for adherence and how to take the drugs at the times required. This process is repeated on the start date of ART. Problems relating to poor adherence are treated on an individual basis, with home visits and hospital appointments thereafter. Many techniques to ease drug administration for children are used. For example alarm wristwatches are provided to remind them to take drugs at the designated times, children are asked to practice preparing drugs during hospital visits, use pill boxes to prepare weekly drugs and a Children's Camp was organized for HIV-infected children where we reiterated the importance of adherence. A clear practice guideline was also produced as a reference point for all team members and weekly team meetings are held, involving all parties to ensure good communication and cooperation among the team. Lesson learned: ARV treatment was started for 8 children in early 2002, 18 children in late 2002, 82 children in 2003 and about 10 children per month in 2004. All children under the care of the team achieved adherence rate of over 95%. Recommendation: The methods and benefits of this experience are being presented to hospital teams all over Thailand through regional meetings and site visits. It shows how a system, promoting adherence can be simple and inexpensive, and can be applied to all hospital teams within Thailand and other resource-limited countries.

Keywords: AEGIS, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, HIV Infections, HIV-1, HIV, Acquired Immunodeficiency Syndrome, HIV Protease Inhibitors, Drug Therapy, Combination, HIV Seropositivity, HIV-1 Reverse Transcriptase, Thailand, Child, Humans, therapy, drug therapy

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WeOrB1324