Health

Detection and management of adverse drug events among people living with HIV to end HIV/AIDs by 2030

Poor adherence leads to an inability to suppress the viral load, an eruption of opportunistic infections, increased likelihood of HIV transmission, drug resistance among others.

The authors; Aisha Naava (L) & Lilian Nuwabaine (R)

Adverse drug reactions may cause treatment interruption, pill sorting and replacement of the prescribed regimen. Clients taking ARVs and anti-TB drugs tend to stop taking medications or pills sort them due to adverse events, which contributes to poor adherence and as a result predisposes them to unsuppressed viral load and advancement of the disease condition. 

Poor adherence leads to an inability to suppress the viral load, an eruption of opportunistic infections, increased likelihood of HIV transmission, drug resistance among others. All these affect the vision of Uganda to end HIV/AIDs by 2030, which states that “zero new infections, zero HIV related deaths and zero discrimination”. 

Some of the factors that contribute to poor adherence among people living with HIV (PLHIV) include multiple co-administration of other drugs with ART due to associated pill-burden, use of other psycho-active drugs but the most important factor is the adverse events encountered by these clients in the due course of treatment. 

If we, as health care workers wait for the patients to tell us whether they have any challenges they face while taking medication, it might be hard because some patients can’t express themselves while others are affected by the attitude of the health care workers.

Of recent, we received a patient at the dispensing area whom we asked whether she had completed taking isoniazid for TB prevention. To our surprise, the patient said she had only swallowed it for one month and stopped because the medicine was causing headache which she never reported to the clinician on the following review visit to the facility but instead just stopped taking that medication.

What does this drive us to? As health workers, we need to make a move from spontaneous to active drug adverse event watchfulness/ observance. Therefore, we call upon all health care providers to our clients to take caution while reviewing them.

Take an extra mile and proactively ask the clients whether they experience any adverse events as they take medication and make sure to manage them as this promotes adherence to the drugs which will help to suppress the viral load and in the long run achievement of the vision to end HIV/AIDs by 2030 in Uganda.
The other important thing is to report the adverse drug events to National Drug Authority as this creates a signal and provision for improvement of the quality of the supply

The authors are; Aisha Naava; Nurse Dispenser working with Kawolo General Hospital and
Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist working with Aga Khan University as the CPD Coordinator & is the Heroes in Health Award Winner-Midwife of the year 2021

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