Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation.
Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation.
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DOI：
10.1007/s10461-022-03602-y
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发表时间：
2022-08
影响因子：
4.4
通讯作者：
Bassett IV
中科院分区：
文献类型：
--
作者：
Bogart LM;Shazi Z;MacCarthy S;Mendoza-Graf A;Wara NJ;Zionts D;Dube N;Govere S;Bassett IV
我们使用实用、稳健的实施和可持续发展模型来评估南非中央慢性药物分配和分销(CCMDD)计划的实施情况，CCMDD是一项差异化服务交付计划，允许临床稳定的艾滋病毒阳性患者在诊所或社区接待点接受抗逆转录病毒治疗。在十家诊所，我们对利益相关者(接待点工作人员、CCMDD服务提供商和管理人员)和16个焦点小组(138名患者)进行了109次半结构化访谈。参与者的态度非常好，并表示CCMDD减少了对污名的担忧。患者层面的障碍包括关于CCMDD的教育不足，以及无法在指定日期获得补充。组织层面的障碍包括通信和运输方面的挑战、药品包装和跟踪方面的错误、严格的CCMDD规则以及基础设施不足。建议包括：(1)提供患者教育并改善有关续药的沟通(在患者层面)；(2)提供专门的空间和工作人员，以及持续的培训课程(在组织/诊所层面)；以及(3)允许在取药点续签处方并减少续药频率，并向诊所提供反馈(在CCMDD计划层面)。
We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa’s Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretroviral therapy refills at clinic- or community-based pick-up points. Across ten clinics, we conducted 109 semi-structured interviews with stakeholders (pick-up point staff, CCMDD service providers and administrators) and 16 focus groups with 138 patients. Participants had highly favorable attitudes and said CCMDD decreased stigma concerns. Patient-level barriers included inadequate education about CCMDD and inability to get refills on designated dates. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid CCMDD rules, and inadequate infrastructure. Recommendations included: (1) provide patient education and improve communication around refills (at the patient level); (2) provide dedicated space and staff, and ongoing training (at the organizational/clinic level); and (3) allow for prescription renewal at pick-up points and less frequent refills, and provide feedback to clinics (at the CCMDD program level).
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
7.2
作者：
Leonard, Chelsea;Lawrence, Emily;Burke, Robert
通讯作者：
Burke, Robert
DOI：
10.4102/hsag.v24i0.1105
发表时间：
2019-01-01
期刊：
Health SA Gesondheid (Online)
影响因子：
--
作者：
Govender, Nishern;Suleman, Fatima
通讯作者：
Suleman, Fatima
影响因子：
2.8
作者：
Magadzire, Bvudzai Priscilla;Marchal, Bruno;Ward, Kim
通讯作者：
Ward, Kim
影响因子：
1.7
作者：
Guest, Greg;Bunce, Arwen;Johnson, Laura
通讯作者：
Johnson, Laura