Appointment / dispensing interval

Clinical description

• Give next appointment date at least 2 days before ARVs would be finished to allow for the safety

buffer.

• Take account of the weekly ART clinic schedule (e.g., Mondays + Wednesdays) when giving the

next appointment. Appointments are usually given for 4, 12 or 24 weeks.

• Patients initiating standard or alternative first line ART must be reviewed clinically at month 1,

and 6 after initiation.

• Thereafter, stable and adherent patients can be given up to 24-week (6-month) appointments.
• In exceptional cases (e.g., international travel), up to 12 months of ARVs can be dispensed.
• Patients starting 2nd or 3rd line ART must be seen every 4 weeks for the first 3 months. Thereafter,

patients who are stable and adherent can be given up to 12-week appointments.

• Align dispensing of CPT and TPT with ART, exposed child follow-up and ANC visits.
• Push back appointment date to allow patients to use up accumulated ‘hanging’ tablets, e.g., give

an appointment after 5 instead of 4 weeks.

Prescribing and dispensing ARVs 75 Table 19: Quantity of ARVs to be supplied by visit interval and daily dose Note: supply and consumption must be calculated separately for each component in the regimen.

Example: separate calculation for ABC/3TC and DTG making up Regimen 15 Total Supply needed Total tabs USED in Dispens. tabs Multiples of full tins interval - Adherence interval taken Actual Tins of 30 Tins of 60 Tins of 90 Tins of 120 Perfect Good per day tabs * tabs tins tabs tins tabs tins tabs tins 100% 95% – 105% 1 30 30 1 60 1 90 1 28 27 – 29 11⁄2 45 90 1 42 40 – 44 2 60 60 1 90 1 56 54 – 58 21⁄2 75 90 3 120 2 90 1 70 67 – 74 3 90 120 2 120 1 84 80 – 88 4 weeks 4 120 120 2 120 1 112 107 – 117 5 150 180 3 140 133 – 147 6 180 180 3 240 2 168 160 – 176 8 240 240 4 224 213 – 235 9 270 300 5 252 240 – 264 1 58 60 2 60 1 90 1 56 54 – 58 11⁄2 87 90 1 84 80 – 88 2 116 120 2 180 2 112 107 – 117 21⁄2 150 180 6 180 3 180 2 145 138 - 152 3 174 180 3 240 2 168 160 – 176 8 weeks 4 232 240 4 240 2 224 213 – 235 5 290 300 5 280 266 – 294 6 348 360 6 360 3 336 320 – 352 8 464 480 8 448 426 – 470 9 522 540 9 504 479 – 529 1 86 90 3 120 2 90 1 84 80 – 88 11⁄2 129 180 2 126 120 – 132 2 172 180 3 180 2 168 160 – 176 12 21⁄2 225 240 8 300 5 270 3 360 3 210 200 - 221 weeks 3 258 300 5 252 240 – 264 4 344 360 6 336 320 – 352 5 430 480 8 420 399 – 441 6 516 540 9 504 479 – 529 1 170 180 6 180 2 168 160 – 176 2 338 360 4 336 319 – 353 24 3 506 540 6 504 479 – 529 weeks 4 674 720 8 672 638 – 706 5 842 900 10 840 798 – 882 6 1010 1080 12 1008 958 – 1058 * Actual tabs needed includes a 2-day safety-buffer