Ramdas Nishana, Meyer Johanna C, Cameron David
Department of Pharmacy, Sefako Makgatho Health Sciences University, South Africa.
Foundation for Professional Development, Pretoria, South Africa.
South Afr J HIV Med. 2015 Jul 1;16(1):347. doi: 10.4102/sajhivmed.v16i1.347. eCollection 2015.
Lost to follow-up (LTFU) is a major challenge that hinders the success of antiretroviral treatment (ART).
To identify factors conducted to a low LTFU rate.
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.
A low LTFU rate (7.9%; = 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.
Achieving a low LTFU rate is possible by having a patient-centred approach and monitoring systems in place.
失访是阻碍抗逆转录病毒治疗（ART）成功的一项重大挑战。
确定导致低失访率的因素。
我们开展了一项分为两部分的描述性和定量研究。第一部分包括对诊所工作人员进行访谈，以确定他们对失访的看法，并建立诊所针对接受抗逆转录病毒治疗患者的随访程序。研究的第二部分是对诊所和患者记录进行回顾性审查。确定失访患者，并联系有联系方式的患者进行电话访谈，以确定他们是否仍在接受抗逆转录病毒治疗和/或他们失访的原因。
确定了较低的失访率（7.9%；n = 683）。工作压力、缺乏交通和资金被报告为失访原因。通过一个电子系统（SOZO）对每月就诊情况、不依从的违约者和失访患者进行跟踪。有助于提高治疗留存率的因素包括：诊所位于市中心，因此距离患者的家或工作地点较近；诊所周六营业，这对那些无法在工作日就诊的患者很方便；有一个既定且严格遵守的预约/挂号系统；在预约前一天发送提醒短信；每次就诊时提供个别咨询服务并在必要时进行转诊；以及诊所拥有稳定的工作人员队伍和支持小组。
通过采用以患者为中心的方法和建立监测系统，可以实现较低的失访率。
