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Adherence to ART
Started by David Okiror, MD on 12 Oct 2009
Last edited by Sophie Beauvais on 25 Nov 2009
I work in rural Liberia,at Kolahun District Hospital. We have a patient who has defaulted on ART three times in two years, previous attempts to engage treatment supporters have failed three times with different people. Every time he comes when he is down with opportunistic infections and begs for re initiation of ART and promises never to default again!
David
Jean Nachega, MD, PhD
Dear David
Any documented reasons (structural? alcohol abuse? etc.) for defaulting ART and/or care? Also documented reasons for failure of social/treatment support strategy (family? friends?)?
Best, Jean
5:34 PM, 12 Oct 2009 | Permalink
David Okiror, MD
Hello Jean,
This guy (40years old) is a driver with no wife or children and lives with his mother, the first treatment buddy was his friend who happens to be a VCT counselor as well and lives with him in the same town. When he is well he is reported to be mobile, he even happens to pass by the hospital while in transit, as we are near the highway, but does not "find time" to drop by and collect his refills! One time he had tuberculosis and after defaulting for three times the doctors decided to confine him in hospital for 8 months in order to get him to complete his course of TB medicines. He is not a known alcoholic, or drug abuser.
What do you think are the possible approaches to handling this kind of case? Because of fear of drug resistance the hospital ART team have decided not to restart his drugs for now as it has become increasingly difficult to get him to adhere. We want to know if there are such experiences out there and what are the best practices.
Cheers
David
6:30 PM, 12 Oct 2009 | Permalink
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