SESSION 19_ ADHERENCE COUNSELING AND ENHANCED ADHERENCE COUNSELLING .pptx

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1. SESSION 19: ADHERENCE COUNSELING AND ENHANCED ADHERENCE COUNSELLING Presenter: Janeth Sabuni Facilitator: Marietha Michael Date : 20 March 2024 MINISTRY OF HEALTH TANZANIA PROJECT ECHO®HIV PATIENT MONITORING TELEECHO™ SESSION 1

2. LEARNING OBJECTIVES By the end of this session, participant are expected to be able to: Explain the difference between Adherence Counseling and Enhanced Adherence Counseling Describe factors that enhance adherence Mention benefits of Adherence Counselling. Describe the consequences of poor adherence to ART 2

3. THE DIFFERENCE BETWEEN ADHERENCE COUNSELING ENHANCED ADHERENCE COUNSELING Adherence counseling Enhanced adherence counseling Adherence Counseling is given to all clients prior to ART initiation Adherence counseling has no time frame Adherence counseling can be individual or group EAC is given to patients with HVL ≥1000 cp/ml to identify and address adherence related issues before the second HVL test Enhanced adherence counseling has time frame-3 months Enhanced adherence counseling should be individual session 3

4. FACTORS THAT ENHANCE ADHERENCE Factors that enhance adherence are categorized as follows: Client related factors Health service providers related factors include Regimen-related factors 4

5. CLIENT FACTORS (1/2) Disclosure of HIV status Readiness to be on life-long medication The understanding that the first-line ART regimen has the best chance of long-term success 5

6. CLIENT FACTORS (2/2) The understanding on the advantages and disadvantages of adhering to ARVs Involvement of a treatment supporter/family member Readiness to participate in Couple/Family counselling. 6

7. HEALTH SERVICE PROVIDERS RELATED FACTORS Agreement between a client and HSPs on the treatment plan Building a trusting relationship with the clients Supportive, non-judgmental attitudes and behaviours of the HSPs Linkages to community support services Teamwork approach by HSPs Health education to clients at every clinical encounter with emphasis on adherence and possible side effects associated with ART 7

8. REGIMEN-RELATED FACTORS Use of fixed drug combinations to reduce pill burden Minimize Drug interactions and side effects through rational drug selection Observe ARVs medication requirements (e.g. with food, without food, etc.) 8

9. BENEFITS OF ADHERENCE COUNSELLING It help clients/patients develop an understanding of their treatment and its challenges Prepare clients/patient to be initiated treatment. Provide ongoing support for clients/patients to adhere to treatment over the long term Help clients/patients develop good treatment taking behavior. Help client/patient set goals for their treatment. 9

10. CONSEQUENCES OF POOR ADHERENCE TO ART Treatment failure HIV drug resistance Increase HIV transmission Increased morbidity and mortality due to Opportunistic Infections. Growth and developmental faltering in children. 10

11. SESSION REVIEW Differentiate between Adherence counseling & Enhanced adherence counseling Mention factors that enhance adherence What are the benefits of adherence? What are the consequences of poor adherence. 11

12. KEY MESSAGES Adherence Counseling is given to all clients prior to ART initiation Enhanced Adherence Counseling is done to identify and address adherence related issues before making the decision to switch the patient to 2 nd line ARV regimen Factors that enhance adherence are categorized as follows: Client related factors Health service providers related factors include Regimen-related factors 12

13. REFERENCES National Guideline for the Management of HIV and AIDS-2019 Orientation of Healthcare Providers on Initiation and Management of Clients on Third line ART (Participant Handbook-NACP, March 2021) 13

14. THANK YOU FOR YOUR PARTICIPATION 14