Antiretroviral Dispensing Tool Ensures Uninterrupted Supply for HIV Patients in Kenya

 {Photo credit: Yvonne Otieno/MSH.}Dr. Rafida, a pharmacist at Coast Provincial General Hospital, enters patient information into the ADT pharmacy management software.Photo credit: Yvonne Otieno/MSH.

“My wife was the first to discover her status. After giving birth, she started feeling unwell and […] tested positive for HIV,” says Mzee Ahmed*, who later learned his son, Juma, was also HIV positive.

“After learning my wife’s status, it took me awhile to get tested but I eventually got the courage to get tested. The test was positive and I was also put on antiretroviral treatment,” explains Ahmed.

Six years later, they all remain on their antiretroviral (ARV) drug regimens and visit health facilities regularly to refill their ARV prescriptions.

ARVs work to suppress the viral load and boost the immunity of HIV patients while reducing the risk of opportunistic infections. It’s a complex, life-long treatment that requires strict adherence. Missing a routine doctor's appointment, or failure to take medication properly can put a patient at risk of developing more severe symptoms, contracting an opportunistic infection, or developing drug resistance.

Ahmed explains that when they were put on antiretroviral treatment, he and his wife were given specific instructions on how and when to take their ARVs and set up regular appointments for check-ups and prescription refills. So far, they have yet to miss a dose.

The Ahmed family is not alone. Patients at the Port Reitz hospital, where Ahmed's family receives treatment, are increasingly finding it easier to get their ARVs on time and stick to their treatment regimens.

Dr. Dominic Miruka Nyamwega, a pharmacist at Port Rietz Hospital, credits the availability of drugs to the use of an Antiretroviral Dispensing Tool (ADT), an easy-to-use electronic pharmacy management software which tracks patient information and monitors the ARVs being prescribed and dispensed. 

The ADT tool is being rolled out in more than 320 health facilities throughout Kenya with support from the USAID-funded Heath Commodities and Services Management (HCSM) program, led by Management Sciences for Health (MSH), in collaboration with the Kenya National AIDS & STI Control Programme (NASCOP). The data gathered from the tool allow medical staff to accurately forecast the quantity of medicines that will be needed to effectively provide treatment to patients.

Using the ADT tool, healthcare workers confirm a patient’s personal information, medication history, and current prescriptions, then record the name and batch number of the medicine being dispensed to the patient, along with their next scheduled appointment. 

The ADT tool has also been put to use at Coast Provincial General Hospital—serving over 4000 active patients on ARV treatment—where it has been used to increase the quality of patient care, catch errors in prescriptions or patient information, and alert health workers when patients have missed their appointment or are in danger of running out of ARVs.

“Before the antiretroviral dispensing tool, we used a Daily Activity Register—a thick book in which workers would log dispensing information. With the register there was no way to keep track of patients who had missed their appointments or were at-risk of running out of medicine. Monthly reports would take hours, instead of minutes—as they do using the dispensing tool,” explains Dr. Rafida, a pharmacist at the Coast Provincial General Hospital.

With the ADT tool, social workers can run a daily report which identifies patients who are running low on ARVs or who may have missed an appointment and flags them for further follow up.

The HCSM program, in collaboration with NASCOP, is currently developing a software support package to ensure the long-term sustainability and functionality of the tool so that patients like Ahmed and his family have ready access to the ARVs they need and never have to miss a dose.

Patients' names have been changed to protect privacy.

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