Train health care workers (HCWs) who will be prescribing or dispensing LPV/r pellets.
Successful product rollout requires extensive planning at all levels: developing the guiding policies, updating the standard treatment guidelines, obtaining initial supplies and managing resupply, and collecting data on product supply and uptake. Even if perfectly executed, all of these activities cannot in and of themselves guarantee uptake of LPV/r pellets.
Successful rollout of LPV/r pellets will rest ultimately on how well health care workers have been trained (sensitized) on the new product. Providers who do not have the necessary information will be unable to properly educate their patients. Caregivers who do not understand the new product may have challenges or difficulties using it with their children. The result will be slower uptake of the pellets, meaning that the program will not achieve its goal of transitioning patients to the new product. Stocks of LPV/r will go unused while other formulations of LPV/r will be in short supply. As importantly, children living with HIV may not receive optimal pediatric antiretroviral formulations.
Lpv/r Pellet Considerations
A country that is introducing LPV/r pellets should take a two-pronged approach to educating health care workers. Existing training materials should be updated to include information on LPV/r pellets, and the updated materials should:
- Target population by age and weight band.
- Be incorporated into any ongoing in-service training and pre-service training of new providers
When developing new materials or updating existing materials, try to incorporate both providers' and caregivers' point of view, and try to respond to the kinds of questions that they will have about LPV/r pellets. Topics can include:
- Rationale for using LPV/r pellets, from both a policy and a clinical perspective.
- Program goals for transitioning patients to LPV/r pellets and what they can do at the facility level to facilitate the transition.
- Similarities and differences between LPV/r pellets and other formulations of LPV/r, including dosing and side effects, and advantages and disadvantages.
- Prescribing LPV/r pellets, for new patients and for existing LPV/r patients who are transitioning from another formulation of LPV/r.
- Concerns that the caregiver might have regarding the use of the LPV/r pellets.
- Supply chain management for LPV/r pellets, using either an existing product management system or a system specially implemented for LPV/r pellets
Training sessions should be competency-based; that is, training sessions should focus on what the health care workers will be able to do (the skills they will acquire) by the end of the training. Examples of competency-based objectives, using the topics above as a basis:
By the end of the training, the health care worker will be able to:
- Explain to the caregiver why LPV/r pellets are recommended for young children and in what circumstances (for which patients).
- Explain the health facility's role in the transition of patients to LPV/r pellets and how to manage the transition.
- Define the appropriate criteria for prescribing LPV/r pellets and explain the criteria to the caregiver.
- Determine the appropriate LPV/r formulation for each patient.
- Correctly determine the appropriate pellet dosage based on the patient's weight.
- Explain to the caregiver what to do in special circumstances—such as vomiting or missed doses—and when a caregiver should notify the health care worker.
- Complete records and reports related to the management of LPV/r pellets, including regular reporting and any special reports on LPV/r pellets, including any LMIS/HMIS forms. Read more about the data collection process when creating your distribution plan.
- Calculate resupply quantities of LPV/r pellets.
- Answer common questions that the caregiver may have concerning LPV/r pellets.
Note: Please refer to the Health Care Worker Contents section of this toolkit for additional information about each of the follower health care worker tools:
- About LPV/r Pellets provides information on the latest pellet guidance, why they are recommended for young children, and who meets the criteria to take the LPV/r pellets.
- Decide LPV/r Formulation helps to determine the appropriate LPV/r formulation for the patient.
- Weight Dosing Tool is a simple tool to determine appropriate pellet dosage based on the patient's weight.
- Administer LPV/r Pellets provides detailed written instructions to help accurately prescribe pellets.
- Frequently Asked Questions provides a series of questions and answers that the HCW may have about prescribing pellets.
- Case Examples provide an opportunity to practice using knowledge of LPV/r pellets, based upon various ages, weights, and other patient functional abilities.
- Information for Caregivers provides a series of tools that will assist health care workers in working with and supporting caregivers who will be administering LPV/r pellets to children.
Note: Any existing resources should be updated to include LPV/r pellets.
- Standard Treatment Guidelines: This database summarizes treatment guideline summaries for different countries.