“…Adherence measures can also be influenced by the particular drug [ 137 ], body weight, genetics, metabolism [ 75 , 76 ] and “white coat adherence” (temporary improvement in adherence prior to a clinical visit) [ 15 , 137 ]. White coat adherence particularly applies to blood and urine ART concentrations [ 113 ], which reflect a shorter duration of adherence (3–5 days) [ 100 , 137 , 160 ] than hair (1 month/1 cm hair [ 33 , 117 , 138 ]). Tenofovir, emtricitabine and tenofovir diphosphate in dried blood spots are growing in popularity to measure adherence, but the costs and turnaround time for results still prohibit scale‐up [ 162 ].…”
Introduction:Engagement with HIV care is a multi-dimensional, dynamic process, critical to maintaining successful treatment outcomes. However, measures of engagement are not standardized nor comprehensive. This undermines our understanding of the scope of challenges with engagement and whether interventions have an impact, complicating patient and programmelevel decision-making. This study identified and characterized measures of engagement to support more consistent and comprehensive evaluation. Methods: We conducted a scoping study to systematically categorize measures the health system could use to evaluate engagement with HIV care for those on antiretroviral treatment. Key terms were used to search literature databases (Embase, PsychINFO, Ovid Global-Health, PubMed, Scopus, CINAHL, Cochrane and the World Health Organization Index Medicus), Google Scholar and stakeholder-identified manuscripts, ultimately including English evidence published from sub-Saharan Africa from 2014 to 2021. Measures were extracted, organized, then reviewed with key stakeholders. Results and discussion: We screened 14,885 titles/abstracts, included 118 full-texts and identified 110 measures of engagement, categorized into three engagement dimensions ("retention," "adherence" and "active self-management"), a combination category ("multi-dimensional engagement") and "treatment outcomes" category (e.g. viral load as an end-result reflecting that engagement occurred). Retention reflected status in care, continuity of attendance and visit timing. Adherence was assessed by a variety of measures categorized into primary (prescription not filled) and secondary measures (medication not taken as directed). Active self-management reflected involvement in care and self-management. Three overarching use cases were identified: research to make recommendations, routine monitoring for quality improvement and strategic decision-making and assessment of individual patients. Conclusions: Heterogeneity in conceptualizing engagement with HIV care is reflected by the broad range of measures identified and the lack of consensus on "gold-standard" indicators. This review organized metrics into five categories based on the dimensions of engagement; further work could identify a standardized, minimum set of measures useful for comprehensive evaluation of engagement for different use cases. In the interim, measurement of engagement could be advanced through the assessment of multiple categories for a more thorough evaluation, conducting sensitivity analyses with commonly used measures for more comparable outputs and using longitudinal measures to evaluate engagement patterns. This could improve research, programme evaluation and nuanced assessment of individual patient engagement in HIV care.
“…Adherence measures can also be influenced by the particular drug [ 137 ], body weight, genetics, metabolism [ 75 , 76 ] and “white coat adherence” (temporary improvement in adherence prior to a clinical visit) [ 15 , 137 ]. White coat adherence particularly applies to blood and urine ART concentrations [ 113 ], which reflect a shorter duration of adherence (3–5 days) [ 100 , 137 , 160 ] than hair (1 month/1 cm hair [ 33 , 117 , 138 ]). Tenofovir, emtricitabine and tenofovir diphosphate in dried blood spots are growing in popularity to measure adherence, but the costs and turnaround time for results still prohibit scale‐up [ 162 ].…”
Introduction:Engagement with HIV care is a multi-dimensional, dynamic process, critical to maintaining successful treatment outcomes. However, measures of engagement are not standardized nor comprehensive. This undermines our understanding of the scope of challenges with engagement and whether interventions have an impact, complicating patient and programmelevel decision-making. This study identified and characterized measures of engagement to support more consistent and comprehensive evaluation. Methods: We conducted a scoping study to systematically categorize measures the health system could use to evaluate engagement with HIV care for those on antiretroviral treatment. Key terms were used to search literature databases (Embase, PsychINFO, Ovid Global-Health, PubMed, Scopus, CINAHL, Cochrane and the World Health Organization Index Medicus), Google Scholar and stakeholder-identified manuscripts, ultimately including English evidence published from sub-Saharan Africa from 2014 to 2021. Measures were extracted, organized, then reviewed with key stakeholders. Results and discussion: We screened 14,885 titles/abstracts, included 118 full-texts and identified 110 measures of engagement, categorized into three engagement dimensions ("retention," "adherence" and "active self-management"), a combination category ("multi-dimensional engagement") and "treatment outcomes" category (e.g. viral load as an end-result reflecting that engagement occurred). Retention reflected status in care, continuity of attendance and visit timing. Adherence was assessed by a variety of measures categorized into primary (prescription not filled) and secondary measures (medication not taken as directed). Active self-management reflected involvement in care and self-management. Three overarching use cases were identified: research to make recommendations, routine monitoring for quality improvement and strategic decision-making and assessment of individual patients. Conclusions: Heterogeneity in conceptualizing engagement with HIV care is reflected by the broad range of measures identified and the lack of consensus on "gold-standard" indicators. This review organized metrics into five categories based on the dimensions of engagement; further work could identify a standardized, minimum set of measures useful for comprehensive evaluation of engagement for different use cases. In the interim, measurement of engagement could be advanced through the assessment of multiple categories for a more thorough evaluation, conducting sensitivity analyses with commonly used measures for more comparable outputs and using longitudinal measures to evaluate engagement patterns. This could improve research, programme evaluation and nuanced assessment of individual patient engagement in HIV care.
“…Most respondents described their dietary habits as good, with 88% adhering to appointments and prescribed medications. Seeking support from family members, health workers, and significant others was preferred, and many engaged in exercises like walking, running, and physical work [23].…”
In pursuance of the Global and National Goals of achieving HIV-AIDS epidemic control, it’s imperative to explore the Promotion of self-care management among people living with HIV/AIDS. Self-care management involves adhering to treatment regimens, good dietary patterns, increased physical exercise, social support, and health-seeking behaviours. The study reviewed five core pillars of self-care management: physical, psychological, emotional, spiritual, and workplace/professional. A cross-sectional descriptive, analytical study with a quantitative approach was conducted at the Antiretroviral Clinic of the University of Abuja Teaching Hospital from October to December 2020. Using random sampling, 372 people living with AIDS participated in the study. Trained research assistants collected data through a structured questionnaire administered at the antiretroviral clinic. The data was analysed using SPSS version 25.0, employing frequencies, computations, percentages, averages, means, standard deviation, and correlations, with a confidence interval of 95%. The study’s findings indicate that the weighted matrix scores (WMS) for various aspects of self-care were significantly above average, suggesting that PLHIV attending the antiretroviral clinic at the University of Abuja Teaching Hospital exhibit good self-care practices. However, psychological and workplace self-care requires some strengthening. The study revealed differences between self-reported appointment adherence and the calculated average appointment gap (3 visits). Associations were found between the average appointment gap and viral load among participants. The study did not establish any significant association between Total Matrixed self-care scores, adherence (appointment gap), or viral load suppression. The COVID epidemic and the nationwide ENDSARS protest in Nigeria during the study period were significant confounders and limitations. Keywords: Antiretroviral drugs, appointment adherence, HIV/AIDS, psychological health, self-care management.
“…Self-care practice is the willingness and awareness of individuals, families, communities, and health workers to overcome disease, improve health status, and prevent complications with or without help from health workers (Oskouie et al, 2017;Kartono et al, 2019). Self-care practices that need to be carried out by PLWHA are adherence to medication regimens, routine control, managing stress, dietary habits, physical activity, exercise, engaging in spiritual activities, symptom management, and seeking information related to disease (Okoronkwo, 2015;(Ibrahim et al, 2021). Factors that influence the self-care practices of PLWHA are knowledge, compliance, social support, health status, and economic status (Wang et al, 2019;Inriyana et al, 2021).…”
People with HIV/AIDS (PLWHA) often have problems with self-care processes due to a lack of knowledge and support from those around them. Education development is needed with the IDEAL model (Include, Discuss, Educate, Assess, Listen), which aims to ensure the continuity of the independent care process at home that PLHIVs carries out with their families. This study aims to determine the effect of providing IDEAL model education on increasing knowledge and self-care practices of people living with HIV/AIDS. The study used a quasi-experiment with a non-equivalent control group using a purposive sampling technique with a total sample of 46 respondents. The results of the t-test in the experimental group's level of knowledge were p-value = 0.000 and self-care p-value = 0.0001 (<0.005); the meaning was an effect before and after giving the intervention. The Manova test results obtained a p-value of 0.133 (> 0.005), meaning interventions. That there was no difference. Educational development using the IDEAL model has been proven to increase the knowledge, abilities, and self-care skills of PLWHA.
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