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Citation Information

Type Journal Article - Tropical Medicine & International Health
Title Medication Adherence Clubs: A Potential Solution to Managing Large Numbers of Stable Patients with Multiple Chronic Diseases in Informal Settlements
Author(s)
Volume 20
Issue 10
Publication (Day/Month/Year) 2015
Page numbers 1265-1270
URL https://www.researchgate.net/profile/Rose_Kosgei/publication/276210440_Medication_Adherence_Clubs_a_​potential_solution_to_managing_large_numbers_of_stable_patients_with_multiple_chronic_diseases_in-in​formal_settlements/links/5580425b08ae712be7a16142.pdf
Abstract
Objectives: To assess the care of hypertension, diabetes mellitus and/or HIV patients enrolled into Medication Adherence Clubs (MACs). Methods: Retrospective descriptive study was carried out using routinely collected programme data from a primary healthcare clinic at informal settlement in Nairobi, Kenya. All patients enrolled into MACs were selected for the study. MACs are nurse-facilitated mixed groups of 25–35 stable hypertension, diabetes mellitus and/or HIV patients who met quarterly to confirm their clinical stability, have brief health discussions and receive medication. Clinical officer reviewed MACs yearly, when a patient developed complications or no longer met stable criteria. Results: A total of 1432 patients were enrolled into 47 clubs with 109 sessions conducted between August 2013 and August 2014. There were 1020 (71%) HIV and 412 (29%) non-communicable disease patients. Among those with NCD, 352 (85%) had hypertension and 60 (15%) had DM, while 12 had HIV concurrent with hypertension. A total of 2208 consultations were offloaded from regular clinic. During MAC attendance, blood pressure, weight and laboratory testing were completed correctly in 98–99% of consultations. Only 43 (2%) consultations required referral for clinical officer review before their routine yearly appointment. Loss to follow-up from the MACs was 3.5%. Conclusions: This study demonstrates the feasibility and early efficacy of MACs for mixed chronic disease in a resource-limited setting. It supports burden reduction and flexibility of regular clinical review for stable patients. Further assessment regarding long-term outcomes of this model should be completed to increase confidence for deployment in similar contexts.

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