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A high adherence level of 80% or more to antihypertensive agent(s) compared to a lower one was related to a risk reduction of ESRD (hazard ratio 0.67; 95% confidence intervals 0.54 0.83).
The high adherence level promises good outcomes once IPT provision becomes a country-wide recommendation in Tanzania.
However, ART is a life-time treatment and sustaining high adherence level should remain the ultimate goal.
Scores of 1 5 indicate low adherence, 6 7 indicate moderate adherence and a score of 8 indicates high adherence level.
Most patients were very confident that they would use their preferred medication as prescribed (preferred medication: 90.8 %, n = 157/173; nonpreferred medication: 46.2 %, n = 80/173) and indicated a high adherence level for medications free of local irritation effects (83.8 %, n = 145/173; Fig. 3).
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In our study, high adherence levels to ART by caretaker report (98%) and medication return (97%) were observed.
In addition, the children had high adherence levels to HAART and the majority experienced viral and immune treatment success with associated improvement in growth.
50 These emerging data may offer partial explanation for the seeming lack of effect of interventions to enhance adherence such as mobile phone reminders within a setting of sufficiently high adherence levels.
To date, however, findings from observational studies have not been encouraging (12), suggesting that very high adherence levels might be needed to produce an impact and that those may be achievable only in intervention settings.
Research is also increasingly available from crisis-affected settings on the outcomes and experiences of offering HIV treatment (anti-retrovirals) in crisis-affected contexts, including from the DRC, where Médecins Sans Frontières (MSF) reported high adherence levels and clients still coming for refills, even during the height of the emergency [ 50].
The higher adherence level (>80%) was associated with higher pharmacological costs (€14,890 vs €7,453), while patients with higher adherence rates had lower nonpharmacological costs (€988 vs €1,255).
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