ArticleGlobal health action2014
Improving adherence to antiretroviral treatment in Uganda with a low-resource facility-based intervention.
Article in Global health action, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Pooled it
- Specification of implementation interventions to address the cascade of HIV care and treatment in resource-limited settings: a systematic review.Implementation science : IS · 2017Pooled it
- Uptake of Appointment Spacing Model of Care and Determinants Among Adult Clients on Antiretroviral Treatment in Ethiopia.Journal of the International Association of Providers of AIDS CarePooled it
- Determinants of implementation of a stepped care intervention for adolescents and youth living with HIV in Kenya: a qualitative evaluation.BMC health services research · 2025Trial
- Trial
- Trial
- Results from a proactive follow-up intervention to improve linkage and retention among people living with HIV in Uganda: a pre-/post- study.BMC health services research · 2018Trial
- Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.AIDS (London, England) · 2018Trial
- Barriers and facilitators to viral load suppression among adolescents and young people living with HIV receiving intensive adherence counselling in east central Uganda: A COM-B model-informed qualitative study.PLOS global public health · 2026Article
- Differentiated antiretroviral distribution: Implementation in five South African districts.African journal of primary health care & family medicine · 2025Article
- Effects of Alcohol Use on Patient Retention in HIV Care in East Africa.AIDS and behavior · 2024Article
- Long-term retention on antiretroviral treatment after enrolment in prevention of vertical HIV transmission services: a prospective cohort study in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2024Article
- Article
- Implementing six multi-month dispensing of antiretroviral therapy in Ethiopia: perspectives of clients and healthcare workers.BMC health services research · 2023Article
- Exploring the barriers to the antiretroviral therapy adherence among people living with HIV in Bangladesh: A qualitative approach.PloS one · 2022Article
- Determinants of Six-Month Appointment Spacing Model Utilization Among ART Clients in the Public Health Facilities of Jimma Town, Southwest Ethiopia: Case-Control Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- A Review of Differentiated Service Delivery for HIV Treatment: Effectiveness, Mechanisms, Targeting, and Scale.Current HIV/AIDS reports · 2019Review
- ART adherence clubs in the Western Cape of South Africa: what does the sustainability framework tell us? A scoping literature review.Journal of the International AIDS Society · 2019Article
- Application of a Multistate Model to Evaluate Visit Burden and Patient Stability to Improve Sustainability of Human Immunodeficiency Virus Treatment in Zambia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the effects of facility-based interventions using existing resources to improve overall patient attendance and adherence to antiretroviral therapy (ART) at ART-providing facilities in Uganda.
methodsThis was an interventional study which tracked attendance and treatment adherence of two distinct cohorts: experienced patients who had been on treatment for at least 12 months prior to the intervention and patients newly initiated on ART before or during the intervention. The interventions included instituting appointment system, fast-tracking, and giving longer prescriptions to experienced stable patients. Mixed-effects models were used to examine intervention effects on the experienced patients, while Cox proportional hazards models were used to determine the intervention effects on time until newly treated patients experienced gaps in medication availability.
resultsIn all, 1481 patients' files were selected for follow-up from six facilities--720 into the experienced cohort, and 761 into the newly treated cohort. Among patients in the experienced cohort, the interventions were associated with a significant reduction from 24.4 to 20.3% of missed appointments (adjusted odds ratio (AOR): 0.67; 95% confidence interval (CI): 0.59-0.77); a significant decrease from 20.2 to 18.4% in the medication gaps of three or more days (AOR: 0.69; 95% CI: 0.60-0.79); and a significant increase from 4.3 to 9.3% in the proportion of patients receiving more than 30 days of dispensed medication (AOR: 2.35; 95% CI: 1.91-2.89). Among newly treated patients, the interventions were associated with significant reductions of 44% (adjusted hazard rate (AHR): 0.56, 95% CI: 0.42-0.74) and 38% (AHR: 0.62; 95% CI: 0.45-0.85) in the hazards of experiencing a medication gap of 7 and 14 days or more, respectively.
conclusionsPatients' adherence was improved with low-cost and easily implemented interventions using existing health facilities' resources. We recommend that such interventions be considered for scale-up at national levels as measures to improve clinic attendance and ART adherence among patients in Uganda and other low-resource settings in sub-Saharan Africa.
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