Background Neighborhood Health Services Corporation (NHSC), an urban community-based not-for-profit ambulatory primary care health centre located in Plainfield, New Jersey, USA, provides HIV care and treatment services to over 350 uninsured, impoverished and minority persons living with HIV/AIDS. To achieve long-term positive health and quality of life outcomes, it is imperative that patients adhere to HIV care and treatment, as well as to prescribed medication regimens.
Methods At NHSC patient-centred adherence efforts begin with a personalised interview. An assessment of patient’s clinical and lifestyle indicators is conducted by clinicians followed by formal adherence education video presentations. Other key components of the adherence strategy are detailed discussions of antiretroviral therapies and potential side effects. Patients are provided with culturally and linguistically sensitive printed materials regarding medications and potential side effects. Free Medication boxes are also provided. Weekly monitoring phone calls are conducted by clinical staff to assess compliance and identify adherence challenges. If patients miss appointments, confidential phone calls are placed to reschedule. Treatment Education and Adherence Record is a comprehensive tool that is administered annually to assess adherence, compliance, barriers and any unanticipated outcomes. A multi-disciplinary clinical team led by an Infectious Disease Specialist observes the entire process and monitors patients’ boosted compliance with the project and promotion of overall HIV treatment and medications adherence.
Results Resulting from the patient-centred adherence strategy, NHSC observed: 25% improvement in medical visits no-show rates; 10% decrease in hospitalisation rates. Furthermore, 62% of patients maintained CD4 above 200; 52% of patients have achieved and maintained undetectable viral load.
Conclusions The collected and analysed data suggests that patient-centred adherence efforts help to: reduce no-show rates; minimise side effects and hospitalizations related to missed doses and “drug holidays”; improve and sustain optimal clinical indicators, as well as significantly improve health and quality of life outcomes.
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