Adherence to antiretroviral therapy and its determinants among persons living with HIV/AIDS in Bayelsa state, Nigeria

Background: A high level of adherence is required to achieve the desired outcomes of antiretroviral therapy. There is paucity of information about adherence to combined antiretroviral therapy in Bayelsa State of southern Nigeria. Objectives: The objectives of the study were to determine the level of adherence to combined antiretroviral therapy among the patients, evaluate the improvement in their immune status and identify reasons for sub-optimal adherence to therapy. Methods: The cross-sectional study involved administration of an adapted and pretested questionnaire to 601 consented patients attending the two tertiary health institutions in Bayesla State, Nigeria: The Federal Medical Centre, Yenagoa and the Niger-Delta University Teaching Hospital Okolobiri. The tool was divided into various sections such as socio-demographic data, HIV knowledge and adherence to combined antiretroviral therapy. Information on the patient's CD4+ T cells count was retrieved from their medical records. Adherence was assessed by asking patients to recall their intake of prescribed doses in the last fourteen days and subjects who had 95-100% of the prescribed antiretroviral drugs were considered adherent. Results: Three hundred and forty eight (57.9%) of the subjects were females and 253 (42.1%) were males. The majority of them, 557 (92.7%) have good knowledge of HIV and combined anti-retroviral therapy with a score of 70.0% and above. A larger proportion of the respondents, 441 (73.4%), had > 95% adherence. Some of the most important reasons giving for missing doses include, “simply forgot” 147 (24.5%), and “wanted to avoid the side-effects of drugs” 33(5.5%). There were remarkable improvements in the immune status of the subjects with an increment in the proportion of the subjects with CD4+ T cells count of greater than 350 cells/mm3 from 33 (5.5%) at therapy initiation to 338 (56.3%) at study period (p<0.0001). Conclusion: The adherence level of 73.4% was low which calls for intervention and improvement. The combined antiretroviral therapy has significantly improved the immune status of the majority of patients which must be sustained. “Simply forgot” was the most important reason for missing doses.

Predominant learning styles among pharmacy students at the Federal University of Paraná, Brazil

Background: Learning styles are cognitive, emotional, and physiological traits, as well as indicators of how learners perceive, interact, and respond to their learning environments. According to Honey-Mumford, learning styles are classified as active, reflexive, theoretical, and pragmatic. Objective: The purpose of this study was to identify the predominant learning styles among pharmacy students at the Federal University of Paraná, Brazil. Methods: An observational, cross-sectional, and descriptive study was conducted using the Honey-Alonso Learning Style Questionnaire. Students in the Bachelor of Pharmacy program were invited to participate in this study. The questionnaire comprised 80 randomized questions, 20 for each of the four learning styles. The maximum possible score was 20 points for each learning style, and cumulative scores indicated the predominant learning styles among the participants. Honey-Mumford (1986) proposed five preference levels for each style (very low, low, moderate, high, and very high), called a general interpretation scale, to avoid student identification with one learning style and ignoring the characteristics of the other styles. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: This study included 297 students (70% of all pharmacy students at the time) with a median age of 21 years old. Women comprised 77.1% of participants. The predominant style among pharmacy students at the Federal University of Paraná was the pragmatist, with a median of 14 (high preference). The pragmatist style prevails in people who are able to discover techniques related to their daily learning because such people are curious to discover new strategies and attempt to verify whether the strategies are efficient and valid. Because these people are direct and objective in their actions, pragmatists prefer to focus on practical issues that are validated and on problem situations. There was no statistically significant difference between genders with regard to learning styles. Conclusion: The pragmatist style is the prevailing style among pharmacy students at the Federal University of Paraná. Although students may have a learning preference that preference is not the only manner in which students can learn, neither their preference is the only manner in which students can be taught. Awareness of students’ learning styles can be used to adapt the methodology used by teachers to render the teaching-learning process effective and long lasting. The content taught to students should be presented in different manners because varying teaching methods can develop learning skills in students.