Evaluating the use of job aids and user instructions to improve adherence for the treatment of childhood pneumonia using amoxicillin dispersible tablets in a low-income setting: a mixed-method study.
BMJ Open
; 9(5): e024978, 2019 05 30.
Article
in En
| MEDLINE
| ID: mdl-31152030
ABSTRACT
OBJECTIVES:
We conducted a study to evaluate the use of job aids and simple user instructions to improve adherence for the treatment of childhood pneumonia with amoxicillin dispersible tablet (DT).DESIGN:
A mixed-method study implemented in three phases between October 2015 and February 2016. SETTINGS The study was implemented in two subdistricts of Bangladesh.PARTICIPANTS:
Caregivers of children aged 2-59 months, health service providers and key stakeholders at national and district level.INTERVENTIONS:
An intervention including training and job aids and user-friendly instructions was introduced in one subdistrict while standard amoxicillin DT packaging and instructions with no training served as the control in the comparison subdistrict. PRIMARYOUTCOME:
Adherence behaviour of caregivers of children aged 2-59 months for the treatment of childhood pneumonia with amoxicillin DT.METHODS:
We conducted a survey with 56 caregivers in the intervention subdistrict and 38 caregivers in the comparison subdistrict. We also conducted 44 in-depth interviews to evaluate the job aids and user-friendly instructions with healthcare providers and caregivers to assess the feasibility, usability and acceptability of the tools in intervention subdistrict.RESULTS:
For 5-day treatment course, 32.1% (95% CI 23.1% to 41.1%) of caregivers in the intervention subdistrict and 2.6% (95% CI 0.3% to 7.8%) in the comparison subdistrict maintained full adherence to the amoxicillin DT treatment for pneumonia. More children under 12 months were given age-appropriate treatment than older children. Key stakeholders and healthcare providers considered the use and integration of the tools into the health system to be feasible and acceptable.CONCLUSIONS:
The provision of tools for the treatment of childhood pneumonia with amoxicillin DT had a positive influence on adherence behaviours. These tools can help close information gaps and overcome the barriers posed by medical illiteracy and remembering instructions from providers.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pneumonia
/
Health Knowledge, Attitudes, Practice
/
Caregivers
/
Health Personnel
/
Treatment Adherence and Compliance
/
Amoxicillin
Type of study:
Qualitative_research
Aspects:
Determinantes_sociais_saude
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
BMJ Open
Year:
2019
Document type:
Article
Affiliation country:
Australia