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Evaluation of medication adherence methods in the treatment of malaria in Rwandan infants

Marc Twagirumukiza1, Pierre Claver Kayumba, Jan G Kips

  • 1Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.

Malaria Journal
|July 20, 2010
PubMed

Insights

Electronic pill-box monitoring accurately assessed malaria treatment adherence in Rwandan children, revealing lower consumer adherence during outpatient care compared to healthcare workers. This highlights the importance of advanced monitoring methods for effective treatment evaluation.

Area of Science:

  • Clinical Pharmacy
  • Global Health
  • Pharmacology

Background:

  • Treatment adherence is crucial for malaria control in children.
  • Accurate adherence monitoring is essential for evaluating treatment efficacy.
  • Existing methods like pill counts and self-reports may overestimate adherence.

Purpose of the Study:

  • To compare manual pill count, patient self-report, and electronic pill-box monitoring for evaluating malaria treatment adherence.
  • To assess adherence in a 7-day controlled treatment period for pediatric malaria patients in Rwanda.

Main Methods:

  • Fifty-six children under 5 with malaria received 7-day quinine sulfate treatment.
  • Adherence was assessed using manual pill count, patient self-report, and electronic pill-boxes recording openings.
  • Medication adherence was defined as the proportion of prescribed doses taken.

Main Results:

  • Manual pill count and self-report indicated 100% adherence.
  • Electronic pill-box monitoring showed 90.5% adherence over 7 days.
  • Outpatient adherence (82.7%) was significantly lower than inpatient adherence (99.3%) as detected by electronic monitoring.

Conclusions:

  • Electronic pill-box monitoring is a more accurate method for assessing medication adherence than manual counts or self-reports.
  • Lower consumer adherence in the outpatient setting was identified solely by electronic monitoring.
  • This highlights a discrepancy between healthcare worker and consumer adherence, crucial for optimizing malaria treatment strategies.
Abstract

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