ASC Rural Adherence Intervention

1
ASC Rural Adherence Intervention

• Arm 1 Directly Observed Therapy
• Arm 2 Telephone Buddy Support
• Arm 3 Monthly Panel

2
Prediction Tool

• Chart Abstraction 12
• Viral load 6
• Missed appointments 3
• Mental health diagnosis 3
• Complexity of Regimen 6
• Number of pills 3
• Number of doses per day 3
• Self Report 38
• Adherence 9
• Knowledge 2
• Social situation 16
• Substance abuse 5
• Medication side effects 3
• Depression scale 3
• A score of 19 or greater places a client in a
  more intensive intervention.

3
Gender
4
Age group
5
Racial composition
6
Housing
7
Work for pay?
8
Frequency of paid work
9
Most likely means of acquiring HIV
10
Client estimate of missed doses per week
11
Last time missed medication
12
Preliminary Analysis of CD4 Count
13
Preliminary Analysis of Viral Load
14
Barriers Encountered - Implementation

• Labor intensive
• Data validity missing data points
• Conceptual changes
• Difficulty providing DOT at remote sites
• Telephone installation and usage
• Difficulty recruiting and maintaining volunteers

15
Barriers Encountered - Evaluation

• Missing data points
• Validity of outcome measures

16
Lessons Learned

• DOT looks very promising
• Telephone buddy support does not
• There may be a role for panel will need further
  analysis