Table 4 Interventions suggested by patients for a convenient drug switch

Ensuring good doctor/clinician patient relationship

01

So, the drug substitution in IDI is sort of a teamwork, it is a decision, mutual understanding… It is not like, ‘ah, change!’ no, people will not accept forced switch… [IDI_male patient_ peer leader_ ESE_9]

Adequate preparation for switching to a new drug

15

… Okay, If I have three months, they can call me in the middle then they tell me your next appointment is supposed to be 30th, but we have called you today to tell you about what we may do on the 30th, then they tell me about the new drug… [IDI_male patient_ general clinic_ESE_11]

Home visits during a switch

01

So, after transitioning, you visit them as before, like Dr… used to. That will be better for people. People even will like to change for them. [IDI_female patient general clinic_ESE_23]

Family support therapy

01

I shared this with one family member, and, she asked me about what the doctor had told me, about the new drug… because she is supporting, she was like okay lets us see, if you see anything, you talk to me. [IDI_male patient_general clinic_ESE_11]

Expert peer involvement in drug switching

01

Those that have experienced switch… facilitate them to share about what they have been though… they really prepare their hearts to be expectant. (IDI_male patient_ peer leader_ESE_9]

Counselling about drug switching

05

…. they tell them when they are together, the counsellor comes and talks to them, “we are changing this because of this and this” … [IDI_female patient_ general clinic_SOD_8]

Capacity building for staff at all levels who switch drugs

01

People need… refresher training. Actually many, many people by the countryside, Yeah! Many of those Health Centres at lower levels; they are not yet there… [IDI_male patient_ Co-pay _SOD_16]

Monitoring DTG side effects

04

They need to carry investigations to make sure this person the kidney is either OK or liver; so as not to give a drug, which again worsens someone’s condition. [IDI_male patient_Co-pay_SOD_16]

Community sensitization through community meetings

12

I say there should be doctors moving around sensitizing about the issue… doctors sensitize people during community gathering about that situation… [IDI_female patient general clinic_SOD_22]

Put up information charts about drug switching

04

I do not know how they call it, these charts; you put them up at the waiting area… within the facility here. Some will get interested and start reading and it… [IDI_female patient _co-pay clinic_SOD_25]

Routine health talks about switching

06

Teaching those that came early at 8am, and then another health worker comes in to teach at 11am after the others have come. Most times if you do not come early, you do not even know what is going on. [IDI_female_patient_RSOD_24]

Routine viral load monitoring after switching

03

I mean the viral load testing should be done after a year. Eh, how do I know that it is suppressing…. Whenever I come I ask, “are you taking my viral load, are you taking my viral load?” “No! October….” [IDI_female patient general clinic_SOD_8]

Adequate messaging and explanation about switch benefits

02

I wanted to know why they had changed it to this new drug. Was it any better compared to the other 3 tablets? Was it reducing on the inconveniences of taking it? and the benefits of this new drug. Was it leading us to the discovery? I would have loved to hear that. [IDI_female patient_SOD_1]