Re: Initiating Antiretrovirals in India certain critical issues

[Guest guest]

Research studies have shown that the medical practioners have to be

well trained in prescribing ART drugs in rational sense only. Many

of the medical practioners do not take into consideration the

factors can influence patients' drug adherance capacities and

practices before initiating ART drug therapy.

1.Still there is gross confusion among many medical practitioners

about ideal clinical condition of the patient to start ART. Many

practitioners take into account only the dropped CD4+ count even the

patient is keeping well himself as far as opportunistic infections

are concerned.

2. Socio economic condition of the patient itself alone impact a lot

on the drug adherence. In long run patients cannot afford the drugs

and they end up with having drug resistence. On the other hand there

is lack of concern over Diet relaed issues and multivitamin

supplements which can do a lot better in prevention of opportunistic

infections.

3. Many of the patients are not aware of the fact that they are on

ART and it does many side effects on the health, till the patient

gets well adapted to the drugs. Patients are not properly counselled

on this important issue and practiotioners say that it is not

practically possible for them to counsell and even its not their

responsibility. Practitioners opine that they are the best to take

patients' decisions of initiating drug therapy.

There are alike issues that have to be dealt with practical manner

based purely on policy formulation and implementation.

Pawan

E-mail: <pawanpeacemaker@...>