Introduction
The clinicians are normally faced with the challenge of convincing the patients to continue with a treatment program that goes on for along period of time or even a lifetime (Stuart, 1982, 95). In attempt to improve the adherence of patients to long term treatments, some have come up with the suggestion that the patients be allowed to administer the treatment on their own instead of having it administered to them by a medical personnel.
Some of the possible intervention that can be adopted by the clinicians in order to improve adherence include the encouragement of the patients to be in contact with people of their age who will encourage them and ensure that they take the medication. The other involves having medical personnel administer the treatment to the patient. Finally, the intervention may involve educating the health care providers on how to take care of the patients (Gibson, Abramson and Wood-Baker, 2006, p 328).
The importance/purpose of the study
The study was carried out to determine the impacts of giving financial enticement on patients’ adherence to HIV counseling and testing (Haukoos et. al. 2005). In other words, the aim was determining whether the financial inducement given encouraged patients to complete the HIV counseling and testing. Basically, the participants in the study were selected from the emergency department who identified those that they felt were at high risk of being infected with the virus and referred them for HIV testing and counseling.
The financial incentive offered to participants in the study
The patients were offered twenty five dollars if they managed to complete the HIV counseling and testing. This inducement was given in the second round of the study and its impact was actually felt as it resulted into a 15% increase in the number of patients who completed the HIV counseling and testing (Haukoos et. al. 2005).
The study design employed
The study design employed in this study was observational study mainly because it involves subjecting the participants to interventions and then a conclusion is drawn depending on the reaction of the subjects to the interventions. This study can be referred to as an experiment because it carries out an investigation and it also applies controls. An increase in the number of outpatients who completed the HIV testing and counseling increased with the introduction of the financial incentive. It will therefore be right to conclude that the financial inducements encouraged the outpatients referred by the emergency department to complete the HIV counseling and testing.
The weaknesses and strengths of the study
The major strength of the study is that it increased the number of people who went for the HIV counseling and testing, though it had a major weakness in the selection of the people to include in the study. This is because it depended on the referral from the emergency department which could have been interfered with by the doctor’s prejudice, misconception or bias. The study could have been susceptible to bias because the doctors could have been biased in their referrals and again, the assessment was being done on people who were unwell; this feeling of being unwell could have prompted the patients to go for the testing.
The concept of randomization
Randomization concept refers to the act of selecting the subjects in study randomly (Rosenberger and Lachin, 2002, 15). This study was not random because the participants in the study were actually selected, not randomly, but depending on the how much susceptible they were to HIV infection as deemed by the doctors.
In order to improve the adherence of patients to long term treatments, the patients should be encouraged to be in contact with their peers who will encourage them to take the treatment. The medical personnel should also be trained on how to take care of the patients. Moreover, it is important to encourage people to develop a sense of responsibility over their health and the financial incentive should never be the motivation behind going for the HIV counseling and testing (Lyons, et. al. 2005)
References
Gibson, P. Abramson, M. and Wood-Baker, R. (2006). Evidence-based respiratory medicine. NJ, Wiley-Blackwell.
Haukoos, et. al. (2005). Financial Incentives on Adherence with Outpatient Human Immunodeficiency Virus Testing Referrals from Emergency Department. Academic Emergency Medicine, 12 (7); p. 617.
Lyons, M. S. et al. (2005). Health department collaboration with emergency departments as a model for public health programs among at-risk populations. Web.
Rosenberger, W. Lachin, J. (2002). Randomization in clinical trials: theory and practice. NY, John Wiley and sons.
Stuart, R. (1982). Adherence, compliance, and generalization in behavioral medicine. NN, Bruner/ Mazel.