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Approximately 70% of the 37.9 million people living with HIV globally live in sub-Saharan Africa’s developing countries. Since the peak of the HIV crisis in the early 1990s, South Africa has made huge advances in research, policy, and treatment benefitting the country’s HIV positive citizens enormously. However, challenges still remain—particularly regarding treatment adherence to antiretroviral therapy (ART). Curbing the HIV epidemic requires getting patients on treatment and keeping them on treatment so that the virus is undetectable in their system and can’t be transmitted to other people.
For patients who can access their treatment every month, one of the biggest contributing factors to poor adherence is forgetfulness. It is difficult to remember to take medication daily, especially when a condition requires lifelong treatment. The key to managing the disease is finding simple, cost-effective and innovative strategies to increase treatment adherence. However, factors like low levels of functional literacy, accessibility and cost remain difficult challenges in the journey towards ensuring adherence to antiretroviral therapy.
FebriSol is an adhesive sticker that can be added to ART packaging to assist patients track their progress throughout a monthly course of medication. The adherence system enables daily medication tracking, which has been demonstrated to increase adherence. FebriSol offers a low-cost alternative to expensive blister packaging, often used to increase adherence to oral contraception. Instead, FebriSol utilises cheap, accessible scratch card technology, which is ubiquitous even in developing countries.
According to behavioural economic theory, a cue, an action and a reward are necessary to create a habit. In the case of FebriSol, the patient sees their medication (the cue), takes their pill and scratches off the day’s metallic coating (the action), and is rewarded by revealing a tick which provides positive reinforcement (the reward). Additionally, they can see at a glance whether or not they have taken their medication on any given day.
While FebriSol was originally designed to increase treatment adherence to antiretrovirals in the developing world, it can be added to any medical packaging and can be used to increase adherence to medications like those used in the prevention of malaria, as well as the treatment of tuberculosis, congestive heart failure, hypertension, mental health, diabetes and many more chronic conditions.