- : Ms Word, Ms Word Format
- : 70 Pages
- : ₦5,000
- : 1-5 Chapters
- Click to DOWNLOAD Materials
THE EFFECT OF ADHERENCE COUNSELLING AND SHORT MESSAGE SENDING (SMS) REMINDERS ON ADHERENCE TO TREATMENT IN CLIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN RIVERS STATE
Abstract
Introduction: The advent of Highly Active Anti-retroviral Treatment (HAART) has transformed HIV from a life threatening disease to a chronic illness, giving a new lease on life to the millions of people living with the virus. However adherence levels as high as 95% and above is needed to establish and sustain adequate suppression of viral load, increasing CD4+ cell count and clinical improvement. Interventions to improve adherence among patients on HAART are therefore imperative to enable them overcome the challenges of adherence.
Objective: The aim of the study was to determine the effect of adherence counselling and short message sending reminders as interventions to improve adherence to HAART in patients in selected treatment centres in Rivers State.
Methodology: This was an experimental study, employing a two site, two group randomized control trial. One hundred and four eligible clients were randomized into intervention (n=52) and control (n=52) groups. Information concerning knowledge of adherence, adherence behaviour, patient self-reported adherence and samples for CD4+ cell count were collected pre and post intervention. Patients in the intervention group received adherence counselling once a month and twice weekly SMS reminders for four months. Patients in the control group received standard care as defined by the ART centre. Four focus group discussions were held with 27 study participants post intervention. Data analysis was done using SPSS version 18 and tests of significance and effect sizes were calculated for adherence and CD4+ cell counts with p-value set at 0.05.
Results: The study had a total of 45 males (43.3%) and 59 females (56.7%) with ages ranged 20 to 68 years and mean age of 35.94 +14.9 years. There were no differences
xiii
statistically between any socio-demographic characteristics in the intervention and control groups.
At the end of the intervention period, adherence was significantly higher in the intervention group (76.9%) than in the control group (55.8%) (p=0.022) with a small effect size (Cohen’s w) of 0.224 and RR of 0.75 (0.55 to 0.96). In addition, the mean CD4+ cell counts for the intervention group (574.15 cells/ml) was significantly higher than that of the control group (408.58 cells/ml) (p=0.005) with a medium effect size (Cohen’s d) of 0.560. The responses from the focus group discussions corroborated the findings from the quantitative analysis and shed light on the perceptions of patients as to the impact of these interventions.
Conclusion: Personalized adherence counselling and short message sending reminders are useful tools in promoting adherence. It is therefore recommended that they be incorporated into service delivery at ART centres.
Title Page———i
Certification——–ii
Dedication———iii
Acknowledgement——-iv
Abstract ———vi
Table of Content——–vii
Chapter One
1.0 Introduction ——-1
1.1 Statement of Problem——4
1.2 Purpose of the Study——5
1.3 Significance of Study——8
1.4 Limitation——–9
1.5 Scope of Study——-11
Chapter Two
2.0 Review of Related Literature —-12
2.6 Summary of Literature Review—- 19
Chapter Three
3.0 Research Methodology and Procedure—22
3.1 Population ——–22
3.2 Sample and Sampling Technique—-22
3.3 Validation of the Instrument —-23
3.4 Reliability of the Instrument —–23
3.5 Data Analysis——-23
Chapter Four
4.0 Presentation and Discussion of Result—24
4.1 Analysis and interpretaion of Data—25
4.2 Discussion of Results——38
Chapter Five
5.0. Summary, Conclusion, and Recommendation –40
5.1 Summary——–40
5.2 Conclusion——–41
5.3 Recommendation——42
References ———45
Appendix 1——–47
Appendix ———50
