Adherence Innovation
As mentioned previously, one of the technologies we brought with us to Swaziland is a chart that allows healthcare workers to calculate adherence percentages without a computer. In rural communities and outreach clinics, counting pills by hand often leads to slow or inaccurate conclusions that significantly impact ARV treatment.
This morning, we met with two members, Dr. Joris Vandelanotte and Ms. Karen Abbs, of Columbia University’s International Center for AIDS Care and Treatment Programs (ICAP) to present our technologies. Fortunately for the community, but unfortunately for the advancement of our devices, it seemed that most of the items we brought wouldn’t be appropriate for many of the settings around Mbabane, since a good number of clinics are pretty well equipped. The search continues, consequently, to find rural communities and outreach clinics where we can gather feedback for designs like the centrifuge and hemoglobin assessment.
Though they were all appreciated, the technology that Dr. Vandelanotte seemed most excited to see was our collection of adherence charts. He said that they were a great concept, but that finding a way to account for the excess pills that patients have (when they have leftover pills from the past month’s prescription, they are usually given an entire next month’s prescription, which can skew the adherence calculation if not taken into consideration) would be even better
Our mission for the day began right then and there!
Ben and I got back to the clinic and started working, and ultimately came up with a design modification that we can present in two ways. The gist of the modification (and I hope to post a picture soon to give you a visual) is that the column where one selects ‘number of pills left’ is customizable in order to negate the excess pills from the last prescription. This is done either by displaying a certain flap or sliding a movable strip to a specific location that indicates the number of extra pills. For example, if the patient had two extra pills at the beginning, the healthcare worker selects the flap for two pills, and the place on the ‘number of pills left’ column that normally indicates one pill now indicates three.
This modification looks very promising, and we plan to take it to a rural site on Thursday to try it out. Friday morning, we’ll attend a meeting set up by local healthcare officials (which include representatives from ICAP, Baylor, Clinton Foundation, and the Swazi ministry) to discuss methods of calculating adherence. We’re hoping to show them our design, and gain more helpful feedback. Wish us luck!