Abstract
Background: Lost to follow-up (LTFU) is a major challenge that hinders the success of antiretroviral treatment (ART). Objective: To identify factors conducted to a low LTFU rate. Methods: We conducted a two-part descriptive and quantitative study. Part 1 comprised interviews with clinic staff to determine their perspectives on LTFU and to establish the clinic’s follow-up procedures for patients on ART. Part 2 of the study was a retrospective review of clinic and patient records. LTFU patients were identified and those with contact details were contacted for telephonic interview to determine if they were still on ART and/or their reasons for becoming LTFU. Results: A low LTFU rate (7.9%; N = 683) was identified. Work-related stress, and lack of transport and funds were reported reasons for LTFU. Monthly visits, non-adherent defaulters and LTFU patients were tracked by an electronic system (SOZO). Factors contributing to high rates of retention in care were: location of the clinic in the inner city, thus in close proximity to patients’ homes or work; clinic operating on Saturdays, which was convenient for patients who could not attend during the week; an appointment/booking system that was in place and strictly adhered to; a reminder SMS being sent out the day before an appointment; individual counselling sessions at each visit and referrals where necessary; and a stable staff complement and support group at the clinic. Conclusion: Achieving a low LTFU rate is possible by having a patient-centred approach and monitoring systems in place.
Highlights
Adhering to antiretroviral treatment (ART) is a lifelong commitment that requires patients to diligently adhere to daily medication dosing schedules and make regular clinic visits for care.[1]
ART has improved the lives of many people living with the human immunodeficiency virus (HIV), but many challenges still exist before ART programmes might achieve total success in terms of patient outcomes.[1]
Interviews with staff members revealed that the clinic followed a structured patient flow process, according to which patients were seen by appointment only and according to bookings done on the SOZO system
Summary
Adhering to antiretroviral treatment (ART) is a lifelong commitment that requires patients to diligently adhere to daily medication dosing schedules and make regular clinic visits for care.[1] ART has improved the lives of many people living with the human immunodeficiency virus (HIV), but many challenges still exist before ART programmes might achieve total success in terms of patient outcomes.[1] Two of the major challenges and concerns for ART programmes are retention in care and patients who are lost to follow-up (LTFU).[1] Several studies have been conducted on these problems, investigating various ways to improve retention in HIV care and patient outcomes.. Lost to follow-up (LTFU) is a major challenge that hinders the success of antiretroviral treatment (ART)
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