Optimising adherence to childhood pneumonia treatment: the design and development of patient instructions and a job aid for amoxicillin dispersible tablets.
BACKGROUND
Pneumonia is the leading cause of death from infection in children worldwide. Despite global treatment recommendations that call for children with pneumonia to receive amoxicillin dispersible tablets, only one-third of children with pneumonia receive any antibiotics and many do not complete the full course of treatment. Poor adherence to antibiotics may be driven in part by a lack of user-friendly treatment instructions.


OBJECTIVE
In order to optimise childhood pneumonia treatment adherence at the community level, we developed a user-friendly product presentation for caregivers and a job aid for healthcare providers (HCPs). This paper aims to document the development process and offers a model for future health communication tools.


METHODS
We employed an iterative design process that included document review, key stakeholder interviews, engagement with a graphic designer and pre-testing design concepts among target users in India and Kenya. The consolidated criteria for reporting qualitative research were used in the description of results.


RESULTS
Though resources for pneumonia treatment are available in some countries, their content is incomplete and inconsistent with global recommendations. Document review and stakeholder interviews provided the information necessary to convey to caregivers and recommendations for how to present this information. Target users in India and Kenya confirmed the need to support better treatment adherence, recommended specific modifications to design concepts and suggested the development of a companion job aid. There was a consensus among caregivers and HCPs that these tools would be helpful and improve adherence behaviours.


CONCLUSIONS
The development of user-friendly instructions for medications for use in low-resource settings is a critically important but time-intensive and resource-intensive process that should involve engagement with target audiences.
PATH, Seattle, Washington, USA.
Kelly
K
Ebels
PATH, Seattle, Washington, USA.
Dunia
D
Faulx
PATH, Seattle, Washington, USA.
Emily
E
Gerth-Guyette
PATH, Nairobi, Kenya.
Peninah
P
Murunga
Hi-Tech Medical College, Bhubaneswar, India.
Samarendra
S
Mahapatro
The INCLEN Trust International, New Delhi, India.
Manoja Kumar
MK
Das
PATH, Seattle, Washington, USA.
Amy Sarah
AS
Ginsburg
D000658:Amoxicillin / Q000008:administration & dosage* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D017028:Caregivers / Q000193:education; D002648:Child; D003142:Communication; D017714:Community-Acquired Infections / Q000188:drug therapy; D006266:Health Education / Q000379:methods*; D006282:Health Personnel / Q000193:education; D006801:Humans; D007194:India; D007630:Kenya; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D036301:Qualitative Research; D013607:Tablets; D016903:Drug Monitoring
D000900:Anti-Bacterial Agents; D013607:Tablets; D000658:Amoxicillin
Comm Child Health; Infectious Diseases; Medical Education; Pharmacology; Qualitative research