Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda

Abstract Background In 2019, the World Health Organisation (WHO) recommended Dolutegravir (DTG) as the preferred first-line antiretroviral treatment (ART) for all persons with HIV. ART regimen switches may affect HIV treatment adherence. We sought to describe patient experiences switching from EFV t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Adelline Twimukye, Miriam Laker, Eva Agnes Laker Odongpiny, Florence Ajok, Henry Onen, Ivan Kalule, Phoebe Kajubi, Kay Seden, Noela Owarwo, Agnes Kiragga, Mari Armstrong-Hough, Anne Katahoire, Andrew Mujugira, Mohammed Lamorde, Barbara Castelnuovo
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HIV Dolutegravir Drug switching Qualitative research Uganda Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/4e44c82667bb4af7ad5d72f67e6e462a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4e44c82667bb4af7ad5d72f67e6e462a
record_format	dspace
spelling	oai:doaj.org-article:4e44c82667bb4af7ad5d72f67e6e462a2021-11-14T12:44:15ZPatient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda10.1186/s12879-021-06851-91471-2334https://doaj.org/article/4e44c82667bb4af7ad5d72f67e6e462a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06851-9https://doaj.org/toc/1471-2334Abstract Background In 2019, the World Health Organisation (WHO) recommended Dolutegravir (DTG) as the preferred first-line antiretroviral treatment (ART) for all persons with HIV. ART regimen switches may affect HIV treatment adherence. We sought to describe patient experiences switching from EFV to DTG-based ART in Kampala, Uganda. Methods Between July and September 2019, we purposively sampled adults living with HIV who had switched to DTG at the Infectious Diseases Institute HIV clinic. We conducted in-depth interviews with adults who switched to DTG, to explore their preparation to switch and experiences on DTG. Interviews were audio-recorded, transcribed and analysed thematically using Atlas ti version 8 software. Results We interviewed 25 adults: 18 (72%) were women, and the median age was 35 years (interquartile range [IQR] 30–40). Median length on ART before switching to DTG was 67 months (IQR 51–125). Duration on DTG after switching was 16 months (IQR 10–18). Participants reported accepting provider recommendations to switch to DTG mainly because they anticipated that swallowing a smaller pill once a day would be more convenient. While most participants initially felt uncertain about drug switching, their providers offer of frequent appointments and a toll-free number to call in the event of side effects allayed their anxiety. At the same time, participants said they felt rushed to switch to the new ART regimen considering that they had been on their previous regimen(s) for several years and the switch to DTG happened during a routine visit when they had expected their regular prescription. Some participants felt unprepared for new adverse events associated with DTG and for the abrupt change in treatment schedule. Most participants said they needed additional support from their health providers before and after switching to DTG. Conclusion and recommendations Adults living with HIV stable on an EFV-based regimen but were switched to DTG in a program-wide policy change found the duration between counselling and drug switching inadequate. DTG was nonetheless largely preferred because of the small pill size, once daily dosing, and absence of EFV-like side effects. Community-engaged research is needed to devise acceptable ways to prepare participants for switching ART at scale.Adelline TwimukyeMiriam LakerEva Agnes Laker OdongpinyFlorence AjokHenry OnenIvan KalulePhoebe KajubiKay SedenNoela OwarwoAgnes KiraggaMari Armstrong-HoughAnne KatahoireAndrew MujugiraMohammed LamordeBarbara CastelnuovoBMCarticleHIVDolutegravirDrug switchingQualitative researchUgandaInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV Dolutegravir Drug switching Qualitative research Uganda Infectious and parasitic diseases RC109-216
spellingShingle	HIV Dolutegravir Drug switching Qualitative research Uganda Infectious and parasitic diseases RC109-216 Adelline Twimukye Miriam Laker Eva Agnes Laker Odongpiny Florence Ajok Henry Onen Ivan Kalule Phoebe Kajubi Kay Seden Noela Owarwo Agnes Kiragga Mari Armstrong-Hough Anne Katahoire Andrew Mujugira Mohammed Lamorde Barbara Castelnuovo Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
description	Abstract Background In 2019, the World Health Organisation (WHO) recommended Dolutegravir (DTG) as the preferred first-line antiretroviral treatment (ART) for all persons with HIV. ART regimen switches may affect HIV treatment adherence. We sought to describe patient experiences switching from EFV to DTG-based ART in Kampala, Uganda. Methods Between July and September 2019, we purposively sampled adults living with HIV who had switched to DTG at the Infectious Diseases Institute HIV clinic. We conducted in-depth interviews with adults who switched to DTG, to explore their preparation to switch and experiences on DTG. Interviews were audio-recorded, transcribed and analysed thematically using Atlas ti version 8 software. Results We interviewed 25 adults: 18 (72%) were women, and the median age was 35 years (interquartile range [IQR] 30–40). Median length on ART before switching to DTG was 67 months (IQR 51–125). Duration on DTG after switching was 16 months (IQR 10–18). Participants reported accepting provider recommendations to switch to DTG mainly because they anticipated that swallowing a smaller pill once a day would be more convenient. While most participants initially felt uncertain about drug switching, their providers offer of frequent appointments and a toll-free number to call in the event of side effects allayed their anxiety. At the same time, participants said they felt rushed to switch to the new ART regimen considering that they had been on their previous regimen(s) for several years and the switch to DTG happened during a routine visit when they had expected their regular prescription. Some participants felt unprepared for new adverse events associated with DTG and for the abrupt change in treatment schedule. Most participants said they needed additional support from their health providers before and after switching to DTG. Conclusion and recommendations Adults living with HIV stable on an EFV-based regimen but were switched to DTG in a program-wide policy change found the duration between counselling and drug switching inadequate. DTG was nonetheless largely preferred because of the small pill size, once daily dosing, and absence of EFV-like side effects. Community-engaged research is needed to devise acceptable ways to prepare participants for switching ART at scale.
format	article
author	Adelline Twimukye Miriam Laker Eva Agnes Laker Odongpiny Florence Ajok Henry Onen Ivan Kalule Phoebe Kajubi Kay Seden Noela Owarwo Agnes Kiragga Mari Armstrong-Hough Anne Katahoire Andrew Mujugira Mohammed Lamorde Barbara Castelnuovo
author_facet	Adelline Twimukye Miriam Laker Eva Agnes Laker Odongpiny Florence Ajok Henry Onen Ivan Kalule Phoebe Kajubi Kay Seden Noela Owarwo Agnes Kiragga Mari Armstrong-Hough Anne Katahoire Andrew Mujugira Mohammed Lamorde Barbara Castelnuovo
author_sort	Adelline Twimukye
title	Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
title_short	Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
title_full	Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
title_fullStr	Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
title_full_unstemmed	Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda
title_sort	patient experiences of switching from efavirenz- to dolutegravir-based antiretroviral therapy: a qualitative study in uganda
publisher	BMC
publishDate	2021
url	https://doaj.org/article/4e44c82667bb4af7ad5d72f67e6e462a
work_keys_str_mv	AT adellinetwimukye patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT miriamlaker patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT evaagneslakerodongpiny patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT florenceajok patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT henryonen patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT ivankalule patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT phoebekajubi patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT kayseden patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT noelaowarwo patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT agneskiragga patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT mariarmstronghough patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT annekatahoire patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT andrewmujugira patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT mohammedlamorde patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda AT barbaracastelnuovo patientexperiencesofswitchingfromefavirenztodolutegravirbasedantiretroviraltherapyaqualitativestudyinuganda
_version_	1718429045265268736

Patient experiences of switching from Efavirenz- to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda

Ejemplares similares