1*Ezekoye Ebele Agnes,2Wakdet Lawrence,3Chijioke-Nwauche Ifeayinwa
1Cordis Pharmaceutical Ltd, Community Pharmacy Practice Unit, Port Harcourt, Rivers State, Nigeria
2Consulting Unit, Sa’i Anwara’i Ju’Mai Consultaire, SCL Nigeria Ltd., Abuja, Nigeria
3Department of Clinical Pharmacy and Management, University of Port Harcourt, Nigeria
ABSTRACT
Background: Traditional hospital-based antiretroviral therapy (ART) delivery systems in Nigeria are burdened by overcrowding, long waiting times, and service inefficiencies. To optimize Human Immunodeficiency Virus (HIV) care, differentiated service delivery (DSD) models, specifically community pharmacy-based ART refill programme, were introduced to decentralize routine medication refill for stable patients.
Objectives: This study assessed patient satisfaction, medication adherence, and their associated determinants among stable People Living with HIV (PLHIV) enrolled in the community pharmacy ART refill programme across Rivers State, Nigeria.
Method: A descriptive cross-sectional design with a correlational component was adopted. A total of 284 people living with HIV enrolled in community pharmacy ART refill programs participated in the study. Data were analyzed using Advanced Microsoft Excel 365 for descriptive statistics and WINPEPI version 11.65 for inferential statistics at p<0.05. Result: The socio-demographic findings showed that most participants were aged 38–47 years (38.4%), female (58.5%), had secondary education (45.4%), were married (58.1%), and unemployed (83.1%). The majority had been on ART for 11–15 years (47.2%) and had used community pharmacy refill services for 5–6 years (58.8%). Findings further revealed that 68.0% of respondents were satisfied and 28.2% were highly satisfied with the services provided. ART adherence was generally good, as 97.5% of participants demonstrated good adherence, while 1.4% and 1.1% showed fair and poor adherence, respectively. Chi-square analysis showed significant associations between satisfaction and ART duration (χ²=8.276, p=0.041) as well as community pharmacy refill duration (χ²=10.375, p=0.016). However, no significant relationships were observed between satisfaction and socio-demographic characteristics or ART adherence (p>0.05).
Conclusion: Community pharmacy-based ART refill services provide a highly acceptable model of HIV care among clinically stable PLHIV in Rivers State. The high levels of patient satisfaction observed support the continued implementation and expansion of differentiated service delivery through community pharmacies. Strengthening pharmacist capacity, maintaining service quality, and ensuring uninterrupted ART availability may further improve patient experience and long-term treatment outcomes.
KEYWORDS
HIV, ART adherence, community pharmacy, patient satisfaction, Rivers State, Nigeria.
REFERENCES
1) Abramson J. H, (2011) WINPEPI (PEPI-for-Windows): computer programs for epidemiologists, Epidemiologic Perspectives & Innovations, vol. 8, no. 1, pp. 1–8,. [DOI: 10.1186/1742-5573-8-1]
2) Ajobgor, S. B., Austine, M. C., & Nnadi, C. E. (2022). Correlates and determinants of patient satisfaction among clients on antiretroviral therapy in Cross River State. International Journal of Community Medicine and Public Health, 9(4), 1642–1650.
3) Asieba, O. O., Avong, Y. K., & Kwaghe, V. (2021). Feasibility, retention, and viral suppression outcomes of the community pharmacy artificial therapy refill model in Nigeria. Research in Social and Administrative Pharmacy, 17(8), 1435–1443.
4) Austine, P. K., Ekwuofu, O. I., & Ogaji, D. S. (2024). Narrative review of community pharmacists’ involvement in differentiated service delivery frameworks in West Africa. Med Discoveries, 3(1), 1024–1031.
5) Avong, Y. K., Asieba, O. O., & Oseni, B. A. (2018). Decentralizing HIV care: Evaluation of prescription refill compliance within community pharmacy models in Abuja, Nigeria. Journal of Public Health Policy, 39(3), 312–324.
6) Barnabas, R. V., Szpiro, A. A., Rooyen, H. v., & Asiimwe, S. (2020). Community-pharmacy antiretroviral therapy versus standard clinic-pharmacy services for HIV in South Africa and Uganda (DO ART): A randomized trial. The Lancet Global Health, 8(10), e1305-e1315.
7) Ekwuofu, O. I., Olawepo, J. O., & Austine, P. K. (2023). Interplay between patient satisfaction, adherence patterns, and socio-demographic factors within community pharmacy models. Journal of HIV/AIDS & Social Services, 22(2), 145–158.
8) Ezenduka, C. C., Nnadi, C. E., & Worgu, Q. C. (2025). Longitudinal appraisal of therapeutic relationships and retention metrics in pharmacy-led differentiated care. West African Journal of Pharmacy, 36(1), 45–56.
9) Federal Ministry of Health, Nigeria (2020). National Guidelines for HIV Prevention, Treatment, and Care.
10) Ibiloye, O., Masquiller, C., Jwanie, P., et al. (2022). Community-Pharmacy ART Service Delivery for Key Populations in Sub-Saharan Africa: Scoping Review of Outcomes Along the Continuum of HIV Care. AIDS and Behaviour, 26(7), 2314–2337. https://doi.org/10.1007/s10461-021-03364-7
11) Kwaghe, V. (2023). Clinical outcomes and demographic characteristics of stable HIV patients devolved to community pharmacies. West Africa Journal of Medicine, 42(2), 189–196.
12) Molas, M., Luque, S., & Retamero, A. (2021). Patient satisfaction, acceptability, and limitations of a community pharmacy-supported ART model during the COVID-19 pandemic in Barcelona. Journal of Antimicrobial Chemotherapy, 76(Suppl 2), 44–51.
13) Nigeria HIV/AIDS Indicator and Impact Survey (2018). National Factsheet
14) Nnadi, C. E., Asieba, O. O., & Worgu, Q. C. (2023). Patient satisfaction with differentiated HIV care services provided through community pharmacies in Rivers State. Greener Journal of Medical Sciences, 13(1), 78–86.
15) Nnenna, O. A., Badru, T. M., & Olorunsola, A. O. (2021). Alternative ART delivery models: Evaluating satisfaction among HIV patients receiving home delivery of antiretroviral medications in Abuja, Nigeria. Journal of Clinical and Medical Images, 5(3), 204–211.
16) Olawepo, J. O., Worgu, Q. C., & Ogaji, D. S. (2024). Strengthening differentiated service delivery systems to reach UNAIDS targets: A multi-center evaluation in Nigeria. The Lancet Global Health, 12(5), 789–798.
17) Olorunsola, A. O., Kwaghe, V., & Asieba, O. O. (2019). Client satisfaction and waiting times within community pharmacy antiretroviral therapy refill networks in Akwa Ibom State. Journal of Pharmaceutical Care and Health Systems, 6(2), 114–121.
18) Oseni, B. A., & Erhun, W. O. (2021). Community pharmacists’ involvement in HIV services and client opinions on differentiated care structures in Nigeria. International Journal of STD & AIDS, 32(6), 523–531.
19) Sanwo Olusola, Navindra E. Persaud, Pius Nwaokoro, Augustine Idemudia et al., (2021). Differentiated Service Delivery Models amomh PLHIV in Akwa Ibom and Cross River States, Nigeria during the Covid-19 Pandemic. Journal of the International Aids Society 24(s6):e25807
20) Shabani, A., Uzoma, K. C., & Molas, M. (2024). Effect of community-based multi-month ART dispensing on adherence among youth living with HIV in Tanzania. BMC Infectious Diseases, 24(1), 112–121.
21) UNAIDS. (2024). Global HIV & AIDS statistics — 2024 fact sheet. United Nations Joint Programme on HIV/AIDS. unaids.org
22) Uzoma, K. C. (2024). Behavioral, clinical, and structural factors influencing ART adherence among people living with HIV in Nigeria: A systematic review. Nigerian Journal of Clinical Practice, 27(3), 301–311.
23) Worgu, Q. C., & Ogaji, D. S. (2022). Comparing satisfaction levels among stable HIV clients receiving services from community pharmacies and specialist HIV clinics in Rivers State. Journal of Public Health and Diseases, 5(2), 89–97.
24) Worgu, Q. C., & Ogaji, D. S. (2025). Measuring long-term compliance trends in decentralized care networks using the Morisky Medication Adherence Scale. African Journal of Pharmacy and Pharmacology, 19(1), 12–21.
25) World Health Organization. (2024). Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: Recommendations for a public health approach. World Health Organization. who.int
Cite this article
Agnes, E. E., Lawrence, W., & Ifeayinwa, C. N. (2026). Patient Satisfaction and Medication Adherence with Community Pharmacy Anti-Retroviral Therapy Refill Programme in Rivers State, Nigeria. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(8), 748-757. https://doi.org/10.58806/ijhmr.2026.v5i8n05
