Patient satisfaction with antiretroviral therapy services and associated factors at Gondar town health centers, Northwest Ethiopia: an institution-based cross-sectional study

Satisfaction of antiretroviral therapy services and its associated factors among adult clients attending antiretroviral therapy in Woliso town, Ethiopia

BACKGROUND

Antiretroviral therapy client satisfaction is a significant tool that enables to strengthen the quality of life of the clients. The study aimed to assess the satisfaction of clients with antiretroviral therapy services and its associated factors among adult clients attending antiretroviral therapy.

METHODS

A cross-sectional study was undertaken from 28 August to 27 October 2022. Data were analyzed by using Logistic regression.

RESULT

Clients who did not attend formal education and attended health education information were significantly associated with satisfaction on antiretroviral therapy services.

CONCLUSION

HIV care services should introduce systematic health education programs to improve satisfaction with antiretroviral therapy services.

Patient satisfaction with antiretroviral therapy service provided by pharmacists in Dembia district health institutions, Northwest Ethiopia

BACKGROUND

The patients' perception of the health service is a vital tool for measuring health service quality. Besides, Patient satisfaction is an essential feature in assessing the quality of health services. Health institution leaders are considering quantifiable patient satisfaction data as a means to evaluate the health care service.

METHOD

An institution-based cross-sectional study was employed from 21/8/2022 to 21/9/2022 among 308 patients attending ART pharmacy services in three health institutions of Dembia distinct. Data were collected by using a questionnaire and reviewing medical charts. Results were calculated and presented in the form of texts, tables, and graphs. Variables with a p-value of 0.05 were considered significant determinants of patient satisfaction.

RESULT

A total of 308 HIV patients were recruited with a response rate of 100%. The overall prevalence of satisfaction among respondents was 231(75%). Being unable to read and write [1.21(AOR = 1.07-4.31)] and patient age greater than 48 years 1.9(0.73-2.59) were significantly associated with the level of patient satisfaction. Among the participants 66.9% were satisfied with clear and organized service, and 76% were satisfied with the convenience of a private counseling room.

CONCLUSION

The general patient satisfaction at the antiretroviral therapy clinic did not achieve the national target of 85% satisfaction with significant differences among health centers. Being educated to a higher level, absence of signs and directions to ART clinics, and not having the opportunity to ask questions were the factors influencing patient satisfaction with ART service.

Evaluation of the pediatric antiretroviral therapy service in Gondar city public health facilities-A case study design with mixed methods

BACKGROUND

The pediatric antiretroviral therapy (ART) service is introduced to save lives, restore mental and physical functions, and improve the quality of life of children living with HIV/AIDS. This evaluation aimed to assess the implementation status of the pediatric ART service provision in Gondar city administration health facilities to promote evidence-based decision-making for program improvement.

METHODS

An institutional-based single case-study design with concurrent mixed methods were applied. The service was evaluated by the availability of essential resources, compliance of health providers with the standard guideline, and caregivers' satisfaction dimensions. Document review, key informant interviews, observations, and interviewer-administered exit-interview were conducted. The quantitative data were analyzed in descriptive and analytical, while the qualitative data were transcribed, translated, and thematically analyzed. A logistic regression analysis was performed to identify factors associated with caregivers' satisfaction.

RESULTS

The overall implementation of pediatric ART service was 75.32%. The availability, compliance, and satisfaction were 68.96%, 74.44%, and 84.64%, respectively. Trained healthcare professionals, essential ART drugs, registers, and basic laboratory diagnostic equipment were reasonably available. However, the lack of opportunistic infection medications and adequate rooms were significant gaps in service provision. Respondents noted a shortage of drugs and rooms for consultation and service provision. Short travel distance (AOR = 2.87), low viral load (AOR = 3.15), and sex of caregivers (AOR = 4.98) were significantly associated with good satisfaction.

CONCLUSIONS

The overall implementation of pediatric ART service is well based on the pre-determined judgment criteria. The health facilities and policymakers are advised to focus on availing medications to treat opportunistic infections and expanding the health facility to have enough space for consultation and service provision. Furthermore, particular emphasis should be given to caregivers who come from long distances and patients with a high viral load to increase caregivers' satisfaction.

Satisfaction toward Quality of Care and Associated Factors among Patients Admitted to Gambella General Hospital, Gambella Region, Southwest Ethiopia

Background. Patient satisfaction, the concept continues to become a crucial and commonly used indicator in the sector of health care delivery for determining the quality of health care services. Satisfaction is a highly desirable outcome of clinical care and may even be an element of health status itself. Therefore, a patient’s expression of satisfaction or dissatisfaction can be considered as a judgement on the quality of care in all of its aspects, whatever its strengths and weakness. Objective. The aim of the study is to determine patient satisfaction on the quality of care and associated factors among patients admitted in Gambella General Hospital, Gambella region, southwest Ethiopia, 2020. Methods. A facility-based cross-sectional study design was conducted, and a consecutive sampling technique was used to recruit 271 study subjects among patients admitted to Gambella General Hospital. All patients who stayed at least for five days and were discharged from inpatient wards were considered for this study. A semistructured questionnaire was used for data collection. Data were entered to Epi-data version 4.6 and exported to SPSS V21 for analysis. Binary logistic regression models were fitted to determine statistically significant associations between dependent and independent variables, and multivariable logistic regression with an AOR with a 95% confidence interval was fitted for candidate variables in binary logistic regression, and statistical significance was declared at $p$ value < 0.05. Result. The proportion of net patient satisfaction among the total of 271 respondents was 40.2% (95% CI: 34.36–46.04%). Being government employees (AOR = 0.06, 95% CI: 0.02–0.27), availability signs and direction indicators (AOR = 2.6, 95% CI: 1.18–5.54), provision of adequate information on the treatments (AOR = 2.5, 95% CI: 1.18–5.44), getting provider’s attention (AOR = 3.5, 95% CI: 1.65–7.24), and understanding of specific patient needs and concerns (AOR = 6.04, 95% CI: 2.8–12.88) were found to be significant predicators of patient satisfaction on the quality of care. Conclusion. Less than half of the patients were satisfied with the quality of service delivered in the wards of the hospital. Occupation, signs and directions to follow, getting adequate information about treatment, providers’ attention, and understanding of specific needs and concerns of the patients were the significant factors. Thus, we would recommend that the hospital management should closely work together with health professionals, supportive staff, patients, and other concerned stakeholders to improve admitted patients’ satisfaction with the quality of care. Policymakers advised to develop and institutionalize better interpersonal relations in the health system.

Use of Long-Acting Therapies for HIV Care in Italy: Are People Living with HIV Prepared for Change? A Cross-Sectional Study

Two hundred two people living with HIV (PLWH) selected from outpatients at the Infectious Disease Institute, Fondazione Policlinico Universitario A. Gemelli IRCCS, in Rome (Italy) were consecutively enrolled from May to July 2021. We used an anonymous telephone questionnaire to investigate opinions of PLWH about combined antiretroviral (ARV) therapy and long-acting (LA) formulations of ARVs. All invited participants completed the questionnaire (100%). We found that most PLWH evaluated taking HIV pills for the rest of their life as a continuous, but undemanding commitment (61.4%; n = 124), although they were willing to stop the daily intake of HIV drugs (78.2%, n = 158). Moreover, most PLWH were unaware of the existence of LA therapies at the time of the investigation (60.4%, n = 122). Almost half the PLWH evaluated the need for injections in the hospital as an obstacle (51.4%, n = 104). Regarding the preference between monthly injections and taking pills everyday, most PLWH (68.8%, n = 139) stated that the injection was more advantageous than pills even if they had some pain/swelling at the injection site. The concern about LA therapy indicated most by PLWH was the possible lower efficacy of the drug (83.7%, n = 169). Regarding the possible benefits of LA therapy, those reported most by PLWH were feeling freer because they did not have to remember to take pills everyday (68,8%, n = 139). In conclusion, to date, PLWH in our cohort seem willing to accept LA therapy, but still show some concern about the efficacy of the new therapy and the obligation to come to the hospital to receive it. Thus, clinicians must take into account the needs of their patients and help them overcome their concerns to facilitate the transition to this new therapeutic modality. Clinical Trial Registration Number ID: 2424.

Patient-Reported Treatment Satisfaction and Quality of Life Among People Living with HIV Following the Introduction of Dolutegravir-Based ART Regimens in Ukraine

In 2017, the government of Ukraine initiated its ART Optimization Initiative, revising its national antiretroviral therapy (ART) guidelines and embracing Dolutegravir (DTG) as a backbone of first-line ART regimens. A cross-sectional survey of 464 ART patients from 22 large ART clinics was carried out in mid-2019. The survey assessed patient-reported outcomes (PROS) including treatment satisfaction, physical health, mental health, depression, side effects of ART, and adherence. The associations between ART regimen and PROs were assessed using bivariable and multivariable generalized estimating equations (GEE) models. More than half (55.6%) of the patients were satisfied with their current ART regimen. Less than a half (45.3%) considered their physical health as good while only 36.9% rated their mental health as good, 21.3% reported moderate or severe depression, 82.3% reported no side effect in the past 4 weeks, and 44.4% reported not missing ART medication in the past month. In adjusted analysis, patients starting ART with DTG had higher treatment satisfaction compared to people continuing LPV-based regimens (aOR = 0.49, 95% confidence interval: 0.22-0.90). Also in adjusted analyses, unemployment, low income, and history of injection drug use were associated with unfavorable PROs. While the results indicate modestly favorable effects of ART Optimization, there is clearly a need for complementary interventions to improve PROs among disadvantaged ART patients in Ukraine.

Antiretroviral Therapy Service Quality and Associated Factors at Selected Public Hospitals, Addis Ababa, Ethiopia, 2021

Background

It is important to offer high-quality HIV/AIDS treatment and antiretroviral medication to people living with the disease to improve health outcomes. The quality of health services has become a public health issue.

Objective

To assess ART service quality and associated factors at a selected public hospital, Addis Ababa, Ethiopia, in 2021.

Methods

A mixed study design was used from April to May 2021. Donabedian’s structure–process–outcome model of health care quality was employed as a framework. A total of 420 clients were interviewed to obtain quantitative data, and 08 key informant interviews and 357 program documents were reviewed. Quantitative data were checked, coded, and entered into Epi Info version 7.2 and exported into SPSS windows version 25.0. In the multivariable logistic regression analysis, variables with p-values < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify factors associated with client satisfaction. Qualitative data were transcribed and analysed using the ATLAS.ti version 8 software program and used to complement the quantitative findings.

Results

The overall quality of ART services was 73.3% for the availability of resources, 79.5% for healthcare providers’ compliance with the national guidelines, and 86.4% for client satisfaction with the quality of ART clinical services. Patients who disclosed their HIV status [AOR 10.7, 95% CI: 5.2–22], months of ART [AOR 10.4, 95% CI: 3.89–27.8], age group 34–44, 45–55, and 56–76 years were found to be 5.1, 8.1, and 5 [AOR 5.1,95% CI:1.2–22, AOR 8.1,95% CI:1.9–35.5, AOR 5,95% CI:2.97–9.44], respectively, and consultation time [AOR 3.5, 95% CI: 1.6–7.35] were associated with client satisfaction on the quality of ART clinical services.

Conclusion

This study revealed that the overall quality of ART services in selected Addis Ababa public hospitals was good, although with the availability of resources and compliance health care providers need improvement.

Patient Satisfaction with HIV and AIDS Services in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

BACKGROUND

The World Health Organization and UNAIDS estimated that 36.9 million people were living with HIV in 2017 globally. In the same year, 1.8 million people became newly infected with HIV and 940,000 people died of AIDS-related illnesses. This study aimed to assess patient satisfaction with HIV and AIDS services in Mizan-Tepi University Teaching Hospital (MTUTH), Southwest Ethiopia.

METHODS

A cross-sectional study was conducted from December 01/2018 to January 31/2019 among 348 people living with HIV who were on highly active antiretroviral therapy (HAART). A systematic random sampling technique was applied to select the study participants. Face to face interview was employed using structured questionnaires. The questionnaire consisted of socio-demographic factors, clinical factors, and patient satisfaction indicators for HIV and AIDS services. Level of satisfaction was assessed based on 24 Likert-scale items. Logistic regression analysis was carried out to identify the independent predictors of patient satisfaction with the services given.

RESULTS

A total of 348 respondents completed the interview, of which 213 (61.20%) were male. The mean age of the respondents was 35.67 (SD=8.40). The overall level of clients' satisfaction with HIV and AIDS services was 55.2%. Educational status of secondary school and above [AOR 2.41, 95% CI: 1.24-4.69], duration of advice above 10 min [AOR 1.74, 95% CI: 1.09-2.79], CD4 count >500 [AOR 2.20, 95% CI: 1.37-3.54], and duration of treatment of 2 years and above [AOR 1.93, 95% CI: 1.07-3.49] were identified as factors significantly associated with client satisfaction.

CONCLUSION

Overall, 55.20% of patients were satisfied with HIV and AIDS services given at the ART clinic of MTUTH. Educational status, CD4 count, duration of advice, and duration of treatment were found to be independent predictors of patient satisfaction with ART services. Increasing client satisfaction is important through patient counseling and care.