Optimising adherence to childhood pneumonia treatment: the design and development of patient instructions and a job aid for amoxicillin dispersible tablets

Abstract

The development of user-friendly instructions for medications for use in low-resource settings is a critically important but time-intensive and resource-intensive process that should involve engagement with target audiences.

Evaluating the use of job aids and user instructions to improve adherence for the treatment of childhood pneumonia using amoxicillin dispersible tablets in a low-income setting: a mixed-method study

“…Some of the drivers of poor treatment adherence have been described in the previous literature as low medical literacy,10–12 lower level of education and low family income 13. The potential to overcome barriers to treatment adherence using job aids and simple user instructions are outlined in Ebels et al 14. When patients clearly understand the treatment regimen and are provided with support materials they are more likely to adhere to the recommended treatment 15.…”

“…When patients clearly understand the treatment regimen and are provided with support materials they are more likely to adhere to the recommended treatment 15. Job aids and user instructions should be appropriate for their specific context of use and that can be achieved through engagement with potential users throughout the design and development process 14. Visual tools with pictorial and graphical symbols help to convey intended meaning about the treatment instruction to the patients and caregivers, including those who are illiterate 16 17…”

“…As part of the UNCoLSC, a job aids and user instructions to support WHO recommendations on the use of amoxicillin DT to treat childhood pneumonia were created through an iterative user-centred design and development process, reported elsewhere 14. These job aids and user instructions are intended to help countries introduce amoxicillin DT into their health systems and align their pneumonia treatment policies with global guidelines.…”

Adherence to oral amoxicillin dispersible tablets in children with community-acquired pneumonia enrolled in clinical trials in Malawi

“…Upon enrollment and randomization, the blinded study staff prepared and administered the first dose of study drug and instructed the caregiver how to administer the remaining doses using customized job aids and patient instructions with pictograms [ 4 ]. Children were kept under observation in the hospital (2–24 h in ITIP1 and 48 h in ITIP2) and assessed for treatment failure prior to discharge.…”