St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
School of Public Health, Addis Ababa University, P.O. Box 27285/1000, Addis Ababa, Ethiopia.
Infect Dis Poverty. 2014 Jun 30;3:20. doi: 10.1186/2049-9957-3-20. eCollection 2014.
One way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription program (FBP) and many studies have explained the treatment outcomes after therapeutic food supplementation, though available evidences on adherence levels and factors associated with these sorts of programs are limited. The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use Therapeutic/Supplementary Food (RUF) in Ethiopia.
A facility-based, cross-sectional study supplemented with qualitative methods was conducted among 630 adult HIV + patients. Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence Scale (MMAS-8). The total score on the MMAS-8 ranges from 0 to 8, with scores of <6, 6 to <8, and 8 reflecting low, medium, and high adherence, respectively. Patients who had a low or a moderate rate of adherence were considered non-adherent.
The level of adherence was found to be 36.3% with a 95.0% response rate. With the exception of the educational status, other socio-demographic variables had no significant effect on adherence. Those who knew the benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups. On the other hand, patients who were not informed on the duration of the treatment, those prescribed with more than 2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere. The main reasons for non-adherence were not liking the way the food tasted and missing follow-up appointments. Stigma and sharing and selling food were the other reasons, as deduced from the focus group discussion (FGD) findings.
The observed level of adherence to the FBP program among respondents enrolled in the intervention program was low. The major factors identified with a low adherence were a low level of education, poor knowledge on the benefits of RUF, the longer duration of the program, consuming more than two prescribed sachets of RUF per day, and not being informed about the duration of the treatment. Therefore, counseling patients on the program's benefits, including the treatment plans, would likely contribute to improved adherence.
解决艾滋病毒/艾滋病患者营养不良的方法之一是通过处方食品方案（FBP），许多研究已经解释了治疗性食品补充后的治疗结果，尽管关于这些方案的依从水平和相关因素的现有证据有限。因此，这项研究的结果将有助于增加人们对埃塞俄比亚 Ready-to-Use Therapeutic/Supplementary Food（RUF）的依从性的现有认识。
在 630 名成年艾滋病毒阳性患者中进行了基于机构的横断面研究，并结合了定性方法。使用 Morisky 8 项药物依从性量表（MMAS-8）来衡量他们对 RUF 的依从程度。MMAS-8 的总得分范围为 0 到 8，得分<6、6 到<8 和 8 分别反映低、中、高依从性。低或中依从率的患者被认为是不依从的。
发现依从率为 36.3%，响应率为 95.0%。除了教育程度外，其他社会人口统计学变量对依从性没有显著影响。那些知道 FBP 方案益处的人比参照组更有可能坚持治疗，其可能性是参照组的 1.78 倍。另一方面，未被告知治疗持续时间、每天开超过 2 包以及已服用 RUF 超过 4 个月的患者不太可能坚持治疗。不依从的主要原因是不喜欢食物的味道和错过随访预约。从焦点小组讨论（FGD）的结果中可以推断出，耻辱感、分享和出售食物也是其他原因。
在参与干预计划的受访者中，观察到对 FBP 方案的依从水平较低。确定的低依从性的主要因素是教育程度低、对 RUF 益处的了解程度低、方案持续时间长、每天服用超过两包规定的 RUF 以及未被告知治疗持续时间。因此，对患者进行方案益处的咨询，包括治疗计划，可能有助于提高依从性。
