Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda
Abstract Background Increasing affordability of artemisinin combination therapy (ACT) in the African retail sector could be critical to expanding access to effective malaria treatment, but must be balanced by efforts to protect the efficacy of these drugs. Previous research estimates ACT adherence r...
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ftdoajarticles:oai:doaj.org/article:4228f35825204b8084af4704fd698924 2023-05-15T15:17:33+02:00 Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda Cohen Jessica L Yavuz Elif Morris Alexandra Arkedis Jean Sabot Oliver 2012-03-01T00:00:00Z https://doi.org/10.1186/1475-2875-11-83 https://doaj.org/article/4228f35825204b8084af4704fd698924 EN eng BMC http://www.malariajournal.com/content/11/1/83 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-83 1475-2875 https://doaj.org/article/4228f35825204b8084af4704fd698924 Malaria Journal, Vol 11, Iss 1, p 83 (2012) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2012 ftdoajarticles https://doi.org/10.1186/1475-2875-11-83 2022-12-31T08:11:59Z Abstract Background Increasing affordability of artemisinin combination therapy (ACT) in the African retail sector could be critical to expanding access to effective malaria treatment, but must be balanced by efforts to protect the efficacy of these drugs. Previous research estimates ACT adherence rates among public sector patients, but adherence among retail sector purchasers could differ substantially. This study aimed to estimate adherence rates to subsidized, over-the-counter ACT in rural Uganda. Methods An intervention study was conducted with four licensed drug shops in Eastern Uganda in December 2009. Artemether-lumefantrine (AL) was made available for sale at a 95% subsidy over-the counter. Customers completed a brief survey at the time of purchase and then were randomly assigned to one of three study arms: no follow-up, follow-up after two days or follow-up after three days. Surveyors recorded the number of pills remaining through blister pack observation or through self-report if the pack was unavailable. The purpose of the three-day follow-up arm was to capture non-adherence in the sense of an incomplete treatment course ("under-dosing"). The purpose of the two-day follow-up arm was to capture whether participants completed the full course too soon ("over-dosing"). Results Of the 106 patients in the two-day follow-up sample, 14 (13.2%) had finished the entire treatment course by the second day. Of the 152 patients in the three-day follow-up sample, 49 (32.2%) were definitely non-adherent, three (2%) were probably non-adherent and 100 (65.8%) were probably adherent. Among the 52 who were non-adherent, 31 (59.6%) had more than a full day of treatment remaining. Conclusions Overall, adherence to subsidized ACT purchased over-the-counter was found to be moderate. Further, a non-trivial fraction of those who complete treatment are taking the full course too quickly. Strategies to increase adherence in the retail sector are needed in the context of increasing availability and affordability of ACT in this ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 11 1 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Cohen Jessica L Yavuz Elif Morris Alexandra Arkedis Jean Sabot Oliver Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Increasing affordability of artemisinin combination therapy (ACT) in the African retail sector could be critical to expanding access to effective malaria treatment, but must be balanced by efforts to protect the efficacy of these drugs. Previous research estimates ACT adherence rates among public sector patients, but adherence among retail sector purchasers could differ substantially. This study aimed to estimate adherence rates to subsidized, over-the-counter ACT in rural Uganda. Methods An intervention study was conducted with four licensed drug shops in Eastern Uganda in December 2009. Artemether-lumefantrine (AL) was made available for sale at a 95% subsidy over-the counter. Customers completed a brief survey at the time of purchase and then were randomly assigned to one of three study arms: no follow-up, follow-up after two days or follow-up after three days. Surveyors recorded the number of pills remaining through blister pack observation or through self-report if the pack was unavailable. The purpose of the three-day follow-up arm was to capture non-adherence in the sense of an incomplete treatment course ("under-dosing"). The purpose of the two-day follow-up arm was to capture whether participants completed the full course too soon ("over-dosing"). Results Of the 106 patients in the two-day follow-up sample, 14 (13.2%) had finished the entire treatment course by the second day. Of the 152 patients in the three-day follow-up sample, 49 (32.2%) were definitely non-adherent, three (2%) were probably non-adherent and 100 (65.8%) were probably adherent. Among the 52 who were non-adherent, 31 (59.6%) had more than a full day of treatment remaining. Conclusions Overall, adherence to subsidized ACT purchased over-the-counter was found to be moderate. Further, a non-trivial fraction of those who complete treatment are taking the full course too quickly. Strategies to increase adherence in the retail sector are needed in the context of increasing availability and affordability of ACT in this ... |
format |
Article in Journal/Newspaper |
author |
Cohen Jessica L Yavuz Elif Morris Alexandra Arkedis Jean Sabot Oliver |
author_facet |
Cohen Jessica L Yavuz Elif Morris Alexandra Arkedis Jean Sabot Oliver |
author_sort |
Cohen Jessica L |
title |
Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
title_short |
Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
title_full |
Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
title_fullStr |
Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
title_full_unstemmed |
Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda |
title_sort |
do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in uganda |
publisher |
BMC |
publishDate |
2012 |
url |
https://doi.org/10.1186/1475-2875-11-83 https://doaj.org/article/4228f35825204b8084af4704fd698924 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 11, Iss 1, p 83 (2012) |
op_relation |
http://www.malariajournal.com/content/11/1/83 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-83 1475-2875 https://doaj.org/article/4228f35825204b8084af4704fd698924 |
op_doi |
https://doi.org/10.1186/1475-2875-11-83 |
container_title |
Malaria Journal |
container_volume |
11 |
container_issue |
1 |
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1766347789211533312 |