Русский
HIV treatment adherence technology: analysis of communications in the specialist-patient system
DOI: https://dx.doi.org/10.18565/epidem.2022.12.1.39-45
Belyaeva V.V., Kozyrina N.V., Sokolova E.V., Semikova S.Yu., Galiullin N.I., Bekbolotov A.A., Beshimov A.T., Berdalieva T.Ch., Narkevich A.N., Lebedeva E.P., Suvorova Z.K., Khokhlova O.N., Shegai M.M.
1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; 3) Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan, Kazan, Russia; 4) Republican AIDS Center, Ministry of Health and Social Development of the Kirgiz Republic, Bishkek, Kirgiz Republic; 5) Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, Krasnoyarsk, Russia; 6) N.A. Semashko Research Institute of Public Health, Moscow, Russia
Subjects and methods. In 2019–2020, a direct written survey of 437 HIV-infected patients was conducted during continuous sampling at the planned follow-up visit. Surveys were made in 161 patients (Group 1) in the Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan, 166 patients (Group 2) in the Leningrad Regional AIDS Center, and 110 patients (Group 3) in the Republican AIDS Center, Ministry of Health and Social Development of the Kyrgyz Republic. The respondents were asked to answer indicator questions to assess the fact and content of conversations made by healthcare workers about HIV infection treatment, and also to assess whether there is enough time at the physician’s appointment to investigate treatment issues.
Results. 46.9%, 91.5%, and 100% of the respondents confirmed that they had been interviewed about their treatment in Groups 1, 2, and 3, respectively. The lowest value of an affirmative answer to this indicator question was observed in Group 1 (p1–2 < 0.001; p1–3 < 0.001). The differences in the value of this indicator between Groups 2 and 3 were also statistically significant (p2-3 = 0.011). An affirmative answer to all the asked indicator questions was obtained; counseling on HIV infection treatment was in full carried out in 22.4, 34.4, and 14.5% of cases in Groups 1, 2 and 3, respectively. Full-scale counseling was most frequently made in the Leningrad Region (p1–2 = 0.050; p1–3 = 0.049; p2-3 < 0.001). However, only a third of the surveyed participants confirmed that they had received counseling in full. In all the groups, the reasons for an impaired medication regimen were least often discussed with 36.5, 47.5, and 29.1% of respondents in Groups 1, 2 and 3, respectively. Most of the respondents noted that there was enough time to investigate treatment issues at the physician’s appointment: these were 88.4%, 88.4%, and 77.3%, respectively.
Conclusion. The findings may suggest that in the regions where the questionnaire survey is conducted, the directive style of communications prevails in the specialist-patient system, and motivating counseling strategies are insufficiently used. There is a deficit in identifying the risks of non-adherence. Clarification and minimization of the risks of non-adherence, the use of incentives that motivate adherence to the antiretroviral therapy regimen, in particular, reminders of the prospect of improving the health status with regular use of drugs, contribute to enhancing the effectiveness of communications on HIV infection treatment.
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About the Autors
Valentina V. Belyaeva, МD, Leading Researcher, Department of Epidemiology and Prevention of AIDS, Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being, Moscow, Russia; labora-et-ora@yandex.ru; http://orcid.org/0000-0002-4621-7892
Nadezhda V. Kozyrina, Cand. Med. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being, Moscow, Russia; nad-kozyrina@yandex.ru; htpp://orcid.org/0000-0001-5134-0054
Ekaterina V. Sokolova, Cand. Med. Sci., Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being, Moscow, Russia; ekaterinasokolova007@rambler.ru; http://orcid.org/0000-0002-2001-8772
Svetlana Yu. Semikova, Deputy Head Physician, Center for Prevention and Control of AIDS and Communicable Diseases, St.Petersburg, Russia; semsvet@list.ru
Niyaz I. Galiullin, Cand. Med. Sci., Head Physician, Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan, Kazan, Russia; centre.spid@tatar.ru
Aibek A. Bekbolotov, Deputy Director, Republican AIDS Center, Ministry of Health and Social Development of the Kirgiz Republic, Bishkek, Kirgizstan; aibek_0001@mail.ru; https://orcid.org/0000-0001-9931-3311
Airat T. Beshimov, Cand. Med. Sci., Deputy Head Physician for Outpatient Work, Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan, Kazan, Russia; Beshimov@rambler.ru
Tattygul Ch. Berdalieva, Therapist, Head, Department of Follow-Up and Treatment, Republican AIDS Center, Ministry of Health and Social Development of the Kirgiz Republic, Bishkek, Kyrgyzstan; ORCID: farmang@mail.ru; https://orcid.org/0000-0001-8368-7829
Artem N. Narkevich, MD, Associate Professor, Head, Department of Medical Cybernetics and Informatics; Head, Laboratory of Medical Cybernetics and Management in Healthcare, V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; narkevichart@gmail.com; http://orcid.org/0000-0002-1489-5058
Elena P. Lebedeva, Medical Psychologist, Center for Prevention and Control of AIDS and Communicable Diseases, Saint Petersburg, Russia; elenalebedeva@list.ru
Zoya K. Suvorova, Cand, Biol. Sci.; Senior Researcher, Specialized Research Department of AIDS Epidemiology and Prevention, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being,Moscow, Russia; zksu@inbox.ru; https://orcid.org /0000-0003-4055-289X
Olga N. Khokhlova, Cand. Med. Sci., Senior Researcher, Specialized Research Department of AIDS Epidemiology and Prevention, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; x.olia79@mail.ru; https://orcid.org/0000-0001-9736-4043.
Professor Marina M. Shegai, MD; Director Adviser, N.A. Semashko Research Institute of Public Health, Moscow,Russia; mshegai-rhcf@mail.ru https://orcid.org/.0000-0003-4054-1998
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