I can see clearly now: developing an active visualisation device for ART in South Africa

Abstract

Background: Adherence to antiretroviral therapy (ART) remains a significant and costly issue for healthcare in South Africa, where few interventions have been implemented. Active visualisation is a new area of health research, where tools are created to visually demonstrate a disease or treatment process to patients in order to improve understanding and adherence. We developed an active visual demonstration depicting how adherence and non-adherence to ART affects HIV disease progression. Methods: The active visualisation using a Perspex body-shaped container, standard laboratory chemicals, and aspirin tablets was used in a randomised controlled intervention study to improve adherence to ART in a South African community hospital. We recruited 78 patients from Helderberg Hospital in Western Cape from May to November 2016. 34 participants were randomised to the intervention and answered quantitative and qualitative questions regarding feasibility and acceptability of the device. Findings: There were no significant changes in illness perceptions from baseline to after seeing the device in the intervention group. Participants reported high levels of satisfaction with the device. Participant’s thoughts when they saw the device were most frequently related to adherence (53.8%, 21/39), and an improved understanding after seeing the device (43.6%, 17/39). Some participants also reported concern beliefs after seeing the device (17.9%, 7/39). Discussion: A brief, visualisation device showing the purpose of ART appears to have high feasibility and acceptability in a community sample of patients in South Africa. The device may have high clinical applicability as an adherence tool to use with non-adherent patients.