{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:09:37Z","timestamp":1790744977128,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,6,15]],"date-time":"2015-06-15T00:00:00Z","timestamp":1434326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the care of hypertension, diabetes mellitus and\/or <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients enrolled into Medication Adherence Clubs (<jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective descriptive study was carried out using routinely collected programme data from a primary healthcare clinic at informal settlement in Nairobi, Kenya. All patients enrolled into <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s were selected for the study. <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s are nurse\u2010facilitated mixed groups of 25\u201335 stable hypertension, diabetes mellitus and\/or <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients who met quarterly to confirm their clinical stability, have brief health discussions and receive medication. Clinical officer reviewed <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s yearly, when a patient developed complications or no longer met stable criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1432 patients were enrolled into 47 clubs with 109 sessions conducted between August 2013 and August 2014. There were 1020 (71%) <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and 412 (29%) non\u2010communicable disease patients. Among those with <jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content>, 352 (85%) had hypertension and 60 (15%) had <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>, while 12 had <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> concurrent with hypertension. A total of 2208 consultations were offloaded from regular clinic. During <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> attendance, blood pressure, weight and laboratory testing were completed correctly in 98\u201399% of consultations. Only 43 (2%) consultations required referral for clinical officer review before their routine yearly appointment. Loss to follow\u2010up from the <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s was 3.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates the feasibility and early efficacy of <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>s for mixed chronic disease in a resource\u2010limited setting. It supports burden reduction and flexibility of regular clinical review for stable patients. Further assessment regarding long\u2010term outcomes of this model should be completed to increase confidence for deployment in similar contexts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12539","type":"journal-article","created":{"date-parts":[[2015,5,12]],"date-time":"2015-05-12T04:12:53Z","timestamp":1431403973000},"page":"1265-1270","source":"Crossref","is-referenced-by-count":87,"title":["Medication Adherence Clubs: a potential solution to managing large numbers of stable patients with multiple chronic diseases in informal settlements"],"prefix":"10.1111","volume":"20","author":[{"given":"Kelly B.","family":"Khabala","sequence":"first","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey K.","family":"Edwards","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bienvenu","family":"Baruani","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Sirengo","sequence":"additional","affiliation":[{"name":"National AIDs and STI Control Programme Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phylles","family":"Musembi","sequence":"additional","affiliation":[{"name":"MOH Langata sub\u2010County Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose J.","family":"Kosgei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology College of Health Sciences University of Nairobi Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kizito","family":"Walter","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Kibachio","sequence":"additional","affiliation":[{"name":"Noncommunicable Diseases Control Unit Kenya Ministry of Health Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Tondoi","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Ritter","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewan","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Chester University Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Reid","sequence":"additional","affiliation":[{"name":"Operational Research Unit M\u00e9decins Sans Fronti\u00e8res Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,15]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"MSF Belgium Kibera(MSF internal report July 2009).Untangling the Web2009."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-371"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12200"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32835e3a56"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318276bea0"},{"key":"e_1_2_6_7_1","unstructured":"Kenya National AIDS Control council.Kenya AIDS indicator survey2012;www.nacc.or.ke\/attachments\/article\/403\/KAIS_II_2014_Final_Report.pdf"},{"key":"e_1_2_6_8_1","unstructured":"SobryA KizitoW Van den BerghRet\u00a0al.Management of hypertension and diabetes mellitus in a primary health care Programme within a slum setting Nairobi Kenya 2013.www.msf.lu\/...\/MSF_OR_Day_2013_Booklet_0."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7196\/sajhivmed.924"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056088"},{"key":"e_1_2_6_11_1","unstructured":"M\u00e9decins Sans Fronti\u00e8resART adherence club report and tool kit2012;http:\/\/www.msf.org.za\/msf-publications\/how-to-keep-art-patients-long-term-care-art\u2010 adherence\u2010club\u2010report\u2010and\u2010toolkit\u20100"},{"key":"e_1_2_6_12_1","unstructured":"WHO.Global update on HIV treatment June 2013: results impact and opportunities2013;http:\/\/www.who.int\/hiv\/pub\/progressreports\/update2013\/en\/index.html"},{"key":"e_1_2_6_13_1","unstructured":"Kenya National Bureau of Statistics.Kenya population and housing census 24th\/25th August 20092009;https:\/\/international.ipums.org\/...\/enum_instruct_ke2009a.pdf"},{"key":"e_1_2_6_14_1","unstructured":"UNAIDS report.Chronic care of HIV and non\u2010communicable diseases. 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