Understanding acceptance of and adherence to a new formulation of paediatric antiretroviral treatment in the form of pellets (LPV/r)—A realist evaluation

by Nebot Giralt A, Nöstlinger C, Lee J, Salami O, Lallemant M, Onyango-Ouma W, Nyamongo I, MarchalI B. PLOS ONE 2019, 14(8): e0220408.  

Summary: The World Health Organisation recommends lopinavir/ritonavir plus two nucleoside reverse transcriptase inhibitors as first-line treatment for all HIV-infected children younger than three years, usually given as a bitter, toxic syrup requiring cold storage; a pellet formulation was developed to overcome these disadvantages. This realist evaluation embedded in a clinical trial assessed factors influencing caregivers’ acceptance of and adherence to lopinavir/ritonavir pellets. Taste masking, neutral packaging and easy storage made the new formulation highly acceptable. Ease of administration, combined with increased self-efficacy and competences of the caregivers, and effective provider support, contributed to high levels of adherence.

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