SUPPORTING PATIENT READINESS AND ADHERENCE THROUGH PATIENT-CENTRED COMMUNICATION
Combined antiretroviral therapy (ART) has drastically reduced HIV-related morbidity and mortality. In clinical practice successful ART requires close collaboration of health care providers and patients over years. The collaboration begins optimally with a shared decision making process about when and how to initiate ART. Once the decision to start has been made, patients need to implement the medication intake into daily life and medication safety has to be monitored. Since ART is a long term treatment with no defined endpoint, persistence to ART has to be maintained by patients over years. To do so patients need to keep up motivation and skills and toxicities have to be monitored carefully.
International care and treatment guidelines provide guidance to health care providers as they support patients making decisions to initiate or change ART. The guidelines reflect evidence based criteria for assessing a patient’s treatment need and treatment options. They also provide guidance for monitoring of ART regimens in respect to safety and toxicities.
However the treatment success of a chosen regimen depends on the readiness of an individual patient to initiate, implement and persist on ART over years. For example: Whereas one patient struggles to find motivation to start ART, because of his health beliefs, another patient has difficulties to find strategies for timely medication intake, because of irregular working hours and fear of HIV-disclosure at the workplace. And a patient, who had adhered to ART over years without problems, suddenly struggles with forgetfulness. As these examples illustrate, barriers to ART experienced by patients can be diverse and individualized and skilled support by providers is needed.
We are involved in health care provider education and we organise national and international workshops. We are planning to focus on culturally-adapted approaches and ART roll-out in particular for Eastern Europe. Furthermore, we will develop, test, evaluate and implement new web-based tools for professionals and patients.
To book a trainer or the training team contact the project coordinator by email