Download - -IAA The Dispensing Based Retrospective Data Collection Adherence Assessment Survey Dispensing 1
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The Dispensing Based Retrospective Data Collection
Adherence Assessment Survey
Dispensing 1
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The Dispensing-based Retrospective Data Collection
The main purpose of this exercise is to find all the adherence indicators except the self report of the exit interview.
As such, it is the single most important exercise of the survey.
Dispensing 2
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Sampling 100 Patient Records
The goal is to follow 100 patient records for six months
Therefore, the sample should be of patients who attended eight months before
For example, the data collection is during October, so sample patients who attended during March
If the patient attended end of March, then six months is completed at the end of September
It is advisable to sample 120 records to end with 100 usable ones
Dispensing 3
Sampling 100 Patient Records
Survey Data Collection Month
Retrospective Sample Month the Previous
January JuneFebruary July
March AugustApril SeptemberMay OctoberJune NovemberJuly December
August JanuarySeptember February
October MarchNovember AprilDecember May
Dispensing 4
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Retrospective Sampling Methods—Examples of Different Situations
Functioning attendance register and patient identification numbers
There is an attendance register, but it does not distinguish between those on ART and those not on ART. However, there is an ART Initiation Register
There is no attendance register, and no ART Initiation Register, but patient identifier number is in order of initiation
There is no attendance register, no ART Initiation Register, and patient identification number is not in order of ART initiation.
Dispensing 5
Methods of Retrospective Sampling-1
Functioning attendance
register and patient identificationnumbers
Yes
Yes
There is an attendanceregister, but it does notdistinguish between
thoseon ART and those not
on ART—however, there is
anART Initiation Register
Randomly sample patients on ART attending in the relevant month and write their name and number on the patient identification sheets. Then pull their pharmacy records.
If most patients are seen every month use ART initiation register. Evenly sample from all the patients who have initiated ART from when the clinic started to up to the end of the month you are sampling.
As a last resort—sample many more than 120 from the attendance register to end up with 100 patients on ART
No
Dispensing 6
No
Methods of Retrospective Sampling-2
There is no attendance register, and no ART Initiation Register, but patient identifier number is in order of initiation
Yes
No
Yes
No
No attendance register, no ART Initiation Register. The patient identification numbers are not allocated in order of ART initiation.
Check how the pharmacy and clinical notes are stored.
If stored in patient identifier order numbers find which number had started by the end of the month for which you are interested and sample all patients who had started before then.
Check the total number of patients on ART now. Check the total number that were on ART 7 months before. Sample from all patients. Sampled size should correspond to the proportion patients started before the end of the month you are interested in.
Dispensing 7
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Retrospective Sampling methods
Any set of circumstances may be met in practice
So far (after 80 facilities in 4 countries), it has always been possible to devise a sensible system for sampling records
You may need to be creative The key is to understand the recording and
storage systems for both the pharmacy records and the attendance register information
Dispensing 8
Retrospective Form
Retrospective Dispensing Data
Date of Entry Facility names
A B C D E G H
Seq.
No.
Patient identifi
er
Initiation of ARVs
Index Visit Dispensing
Age in Yrs at index visit
Gender M/F Date
initiation ARVs
Index visit Date any ARV drugs dispensed
(dd/mm/yy)
# days of ART
dispensed on that
day
1
2
3
Dispensing 9
Take the manual (Chapter 4) and go over filling in the form, column by column.
Retrospective Form
FACILITY #
Name Data Collector
J K N O
Visit 2 Dispensing Visit 3 Dispensing
Date any ARV drugs dispensed
(dd/mm/yy)
# days of ART
dispensed on that day
Date any ARV drugs dispensed
(dd/mm/yy)
# days of ART
dispensed on that day
Dispensing 10
Retrospective Form
BX BY BZ CA
If yes If missed If missed
Did patient
attend 3 months
ago (Y/N)
Attended next appt after visit 3 months ago (Y/N)
Attended in next 3 days
after missed appt
(Y/N)
Attended in next 30
days after missed visit
(Y/N)
Dispensing 11
Looking at Attendance
The longest appointments are for three monthsThis means we want to look at the appointment
more than three months ago. For example, the data collection is during
October Look at attendance during June Find what date the next appointment was given
during this attendance Look at actual attendance and decide whether it
was on or before the due date, within 3 days and within 30 days of due date and fill in accordingly
Dispensing 12
Looking at Attendance
Survey Data Collection Month
For the Appointment after the Attendance month the previous
January SeptemberFebruary October
March NovemberApril DecemberMay JanuaryJune FebruaryJuly March
August AprilSeptember May
October JuneNovember JulyDecember August
Dispensing 13