Assessing the effectiveness of Multi Month Scripting of Anti Retroviral Therapy amongst stable patients: A comparative case of Bwaila Martin Preuss Center and Kapiri In Malawi
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Date
2021-03-17
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Kamuzu University of Health Sciences
Abstract
Type of research: A quantitative multiple retrospective study aimed at evaluating the effectiveness of multi-month scripting (MMS) on ART amongst stable adult patients living with HIV under care using a
comparative case of Bwaila Martin Preuss Clinic in Lilongwe and Kapiri Mission Hospital in
Mchinji, Malawi. Secondary data will be used.
The problem: The United Nations Programme on HIV/AIDS (UNAIDS) and WHO promote adoption of the
Differentiated Service Delivery (DSD) approach with its 95-95-95 targets by 2030. Malawi
adopted the multi-month scripting (MMS) among other models to relieve the burden of frequent 28 September 2016. National Health Sciences Research Committee (NHSRC) number 15/11/1513”.
The study population will include stable adult patients living with HIV on Regimen 5A
TDF/3TC/EFV (300/300/600mg) at Bwaila Martin Pruess Clinic and Kapiri Health Centre. A total of 3,565 patient records receiving three months (90days) dispensing intervals in these two
health facilities will be used for the study. Data used will be secondary quantitative data
collected routinely as part of clinic Electronic Medical Records (EMR) at the two health
facilities. Collected data will be stored securely in computer data base that have a password and
only limited access to key study team will be provided. Stata version 15 will be used for analysis
with summary statistics including percentages, medians and ranges calculated and presented for
quantitative variables. Ethical approval will be sought from the College of Medicine Research
and Ethics Committee (COMREC). Expected findings and their Dissemination:
It is anticipated that the study will generate findings that are well enriched with adequate
information that provides a deep understanding of the subject and contribute meaningfully to the
body of knowledge on Differentiated Service Delivery. We expect to determine the effectiveness
of MMS on ART among stable patients and if patient characteristics are associated with
retention. Research results will be disseminated in writing and presentations. The report will be
submitted to College of Medicine, University of Malawi being the institution to award the
degree. Research findings will be presented to health care workers and senior management teams
the participating health facilities. The researcher will be available to share the results from the
study through local dissemination conferences, seminars and workshops organized by the
College of Medicine’s Research Support Centre (RSC) and Research and Ethics Committee
(COMREC). An abstract will be developed for submission to conferences and publication in
journals.
appointments of patients and providers, freeing up resources to provide more intensive care to
complex patients where HIV mortality is high. Since 2016 all government health facilities in
Malawi have implemented 3 months multi- month scripting for stable patients on ART.
However, there is no evidence on the comparative effect of MMS on improved patient outcomes
in terms of adherence to ART and the influence of the captured patient characteristics on the
adherence to ART. Objectives: The aim of the study is to evaluate the effectiveness of multi-month scripting (MMS) on ART
amongst stable adult patients living with HIV under care using a comparative case of Bwaila
Martin Preuss Clinic in Lilongwe and Kapiri Mission Hospital in Mchinji, Malawi. The study
specifically seeks to determine the effect of MMS on patient retention; assess the patient
characteristics that are associated with the degree of compliance to ART treatment and assess the
influence of patient characteristics on retention in care for patients on MMS. Methodology:
A quantitative multiple retrospective study will be used to evaluate the effectiveness of multi month
scripting (MMS) on ART amongst stable adult patients living with HIV under care at
Bwaila Martin Preuss Clinic in Lilongwe and Kapiri Mission Hospital in Mchinji. Secondary
data analysis will be done on data collected from the study titled “Assessing Implementation of
Models of Differentiated Care for HIV Service Delivery in Malawi: A Process Evaluation dated
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Research Subject Categories::MEDICINE