Establish trust. |
Serve as educator and information source with ongoing support and
monitoring. |
Provide access between visits for questions or problems (eg, by
providing a pager number), including during vacations or conferences. |
Monitor ongoing adherence; intensify management during periods of
suboptimal adherence (ie, more frequent visits, recruitment of family
or friends,
deployment of other team members, and referral for mental health or
chemical-dependency services). |
Use health team for all patients, including patients with special needs
(eg, use peer educators for adolescents or for injection-drug users). |
Consider impact of new diagnoses on adherence (eg, depression, liver
disease, wasting, or recurrent chemical dependency) and include
adherence intervention in management. |
Use nurses, pharmacists, peer educators, volunteers, case managers,
drug counselors, clinician's assistants, nurse practitioners, and
research nurses to reinforce adherence messages. |
Provide training to support team regarding antiretroviral therapy and
adherence. |
Add adherence interventions to job descriptions of support team
members; add continuity-of-care role to improve patient access. |