Antiretroviral drug prescribing practices in the HIV/AIDS treatment in Kampala and its neighbouring Districts
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Background: There is an increase in ARV drug use in Uganda with very many different service providers. Much as there are guidelines to ensure standardized service provision, little was known as to whether these providers follow the recommendations of the guidelines when prescribing ARVs. Previous studies in Uganda had shown that prescribers do not follow the national treatment guidelines meant for the management of other common illnesses, it is therefore highly likely that the same situation exists for HIV/AIDS. Method: The study was conducted through a cross-sectional survey of 20 HIV/AIDS treatment centres randomly selected; a retrospective analysis of 30 patients’ records selected by systematic random sampling from each facility was done. Descriptive analysis to obtain frequencies was done using MS excel 2007. Results: Of the 600 patients 548 (91.3%) of them were initiated after doing a baseline CD4 and 52 (8.7%) were initiated based on the WHO clinical staging of HIV/AIDS as recommended by the guidelines. It was also found that 332 (55.3%) patients were initiated on stavudine based combinations, 207 (34.5%) on Zidovudine based combinations, and 58 (9.7%) on tenofovir based combinations. Frequency of switching ARV drug regimen was 165 (27.5%) with 106 (64.2%) of the patients being switched within the first line alternatives, 58 (34.8%) from first line to second line regimens and 1(0.6%) from NVP for PMTCT to AZT/3TC+EFV. 54 (32.7%) were switched due to Adverse drug effects, 42 (25.5%) due to TB/Pregnancy, 41 (25.01%) due to treatment failure and 28 (16.45%) due to stock out. Conclusion: The study concludes that some prescribers do not follow the recommendations of the 2008 national antiretroviral treatment guidelines while prescribing ARVs and recommends that interventions are put in place to ensure appropriate use of these drugs.