Table 1.
Comparison of standard of care and CACs for the management of ART patients
| Standard of care (CHC) | Community-based adherence clubs (CACs) | |
|---|---|---|
| Setting | Clinic based | Community based |
| Patient profile | All ART patients | Stable patients |
| Key personnel | Doctors/nurses | CHW |
| Frequency of visits | 2 monthly | 2 monthly |
| Frequency of clinical consultations | 2 monthly (every visit) | 12 monthly |
| Location of clinical consultations | CHC | Community based |
| Emphasis of patient contacts | Detecting clinical complications | Treatment adherence, patient wellness |
| Units of care | Individual patient | Groups of 25–30 |
| Peer-based support | No emphasis | Strong emphasis |
| Patient self-management | Minimal emphasis | Strong emphasis |
| Frequency of laboratory monitoring | 6–12 monthly | 12 monthly |
| Management of clinical complications | On-site | Up-referral to CHC |
| ART packing and dispensing | Packed at the CHC pharmacy, dispensed from pharmacy | Pre-packed by central dispensing unit, dispensed at CAC visit |
| Treatment buddy | Patients attend the CHC and collect ART themselves | ART can be collected by a treatment buddy |