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While we did have extensive and systematic adherence data, we did not have as extensive virologic suppression data on all individuals, since some people entered the cohort already on treatment.
The interesting fact that half of our patients used their mobile phones as a medication reminder opens up future opportunities of systematic adherence support through text reminders since cell phone access and usage are rapidly increasing throughout sub-Saharan Africa [50].
Also, videotapes of all individual sessions are available for systematic adherence and competence evaluation.
12 13 The alternative is to use condoms in all sexual contacts, but systematic adherence is difficult for some couples, impedes natural conception, and does not completely eliminate the risk of transmission.
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As recommended by systematic reviews, adherence evaluation was objective, assessed in different points of the intervention and measured two months after its closure.
To be fully beneficial, IMCI should be implemented as a comprehensive strategy rather than a training programme, with special emphasis to systematic planning, adherence to quality criteria of programme implementation, and continuous monitoring of progress and timely feedback.
Although there are systematic reviews of adherence to dietary interventions for individuals with chronic illnesses, adherence to medications, and adherence to group exercise to prevent falls in older adults [ 12- 14], there is no known review of adherence to regular exercise among middle aged women.
Furthermore, in a systematic review of adherence in people with psoriasis none of the studies addressed adherence to recommendations for healthy lifestyle [ 25].
We summarised the findings from Stages 1 and 2 plus two related studies (a systematic review of adherence interventions in chronic respiratory disease and a study measuring predictors of adherence in bronchiectasis [ 3, 4, 23]) and circulated these to participants two weeks prior to the expert panels taking place (Patient version in Additional file 3 and HCP version in Additional file 4).
Other research in this area, such as systematic reviews of adherence interventions [ 5], tends to report that the evidence for the effectiveness of adherence interventions is either limited, short lived in duration of effect, or both.
Future studies and program evaluations should focus on systematic monitoring of adherence and treatment interruptions by using facility-based pharmacy records, understanding threats to optimal adherence and timely linkage to care throughout the displacement cycle, and testing interventions designed to support adherence and treatment outcomes in these settings.
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