Venables, E., Edwards, J.K., Baert, S., et al. PLOS ONE (October 2016), 11(10). doi:10.1371/journal.pone.0164634.
This qualitative study examined clients' and health care workers' (HCWs) experiences with medication adherence clubs (MACs) in the informal urban settlement of Kibera, Kenya. The MACs enable clients with stable noncommunicable diseases (NCDs) and HIV to collect medication every three months through a group setting, rather than through individual appointments. Researchers conducted 10 focus groups, 19 interviews, and 15 participant observation sessions. Results indicated that participants (106 total) viewed MACs as a useful and acceptable way to provide and receive medication. MAC members appreciated the reduced number of appointments and waiting time (saving time and money), the provision of health information, and the support provided by HCWs and peers in a communal setting. Some clients and HCWs felt that MACs reduced stigma for HIV-positive individuals by treating HIV like a NCD. Overall, the majority of clients and HCWs supported integrating HIV and NCD clients into MACs. Challenges may include ensuring that clients have sufficient information during recruitment and development of peer networks. Experiences from MACs in providing decentralized antiretroviral therapy can inform the extension of this model of care to NCD clients. The authors noted that this approach to client-centered drug refill systems for chronic diseases is a feasible and acceptable approach in resource-poor settings.