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Checklist of standard care activities
This checklist was sent to all authors of selected studies to assess the content of standard adherence
care. Authors completed the checklist and added any additional adherence activities that were not
included in the checklist (see “Other […], namely” at the end of each section). Two coders
independently determined which of these activities were considered relevant, i.e. by coding which
of the activities were adequate applications of effective behavior change techniques targeting
important determinants of adherence. Hence, some activities were considered irrelevant for
adherence, others were considered relevant and were therefore included in the standard care quality
scores. Only the relevant activities are included in the checklist below.
Most of the content of this checklist has been included in Table 1 of the manuscript. However,
the activity descriptions in the checklist are more extensive. Moreover, the coders merged some
items in this checklist in 1 behavior change technique and 1 general activity. Table 1 contains the
merged activities while the checklist contains all the separate practical activities (e.g. Information
on HIV, medication and adherence is 1 activity in Table 1 but consists of 5 items in the checklist).
Each activity in the checklist below is followed by a number (e.g. 1) which refers to the coding of the
activity described in the Table at the end of the document (i.e. similar to Table 1 in the manuscript).
Uses of the checklist:

Health care professionals can examine the content and quality of their own standard adherence
care, and determine whether there are additional activities they can adopt to increase the quality
of their adherence care.

Researchers can use the checklist to assess standard adherence care quality in their study setting,
and include the completed checklist in their publications. In case the researcher identifies
additional standard adherence care activities in the study setting, please determine whether these
are relevant before adding them to the checklist (coding manual available from the first author).

Researchers conducting reviews in other behavioral domains than adherence (to HAART) can
use this checklist, and follow the procedure described in the manuscript, to develop domainspecific standard care checklists. These checklists can then be used to assess standard care
activities, and code these activities to determine the quality and effectiveness of standard care in
other domains.
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Below we present a summary of main characteristics of standard care procedures reported by
authors of HAART adherence intervention articles. Some of these characteristics are mentioned
often, others rarely. We would like to know which of these characteristics were part of the
standard care procedures during your study [OR: that the participants in the control condition of
your study received]. With standard care procedures we mean those characteristics of standard care
that were provided systematically to all patients.
In Questions 3 thru 7 the answer options are 1. Yes, 2. No, and 3. ? (=don’t know). Please check only
one of these options.
1. The person(s) who educated the patient and discussed adherence during standard care was a:
[check all that apply]
Nurse
Physician
Pharmacist
Case manager / social worker
Other,
This person (these persons) are from now referred to as the healthcare provider(s) in the remainder of this
questionnaire
2. Is the healthcare provider(s) trained (on-site by competent peers or through formal training) in
patient education and counselling strategies?
Yes, well-trained
Yes, received some training
No, received (almost) no training
I do not know
3. The healthcare provider(s) delivered the following education about HIV and the medication
systematically to all patients:
Yes No
What HIV is and what it does in the body (1)
The meaning of viral load and CD4 (1)
What the medicines do to fight HIV (1)
How the medication should be taken (1)
The importance of adherence and the consequences of non-adherence (4, 8)
What to do if a dose is missed (1)
Common side-effects and how to deal with them (16)
Other education, namely
?
3
4. How was this education provided?
Yes
No
?
5. The healthcare provider assisted patients systematically and consequently in planning their
medication intake by:
Yes No
(8)
Encouraging patients to adhere to the treatment
?
Verbal explanation to the patients*
Use of illustrative materials (e.g., pictures, videos) (2)
Handing out brochures or written information (3)
Other media, namely
*Since counseling in all studies was done verbally, this was considered baseline and not given a quality score.
Developing a medication intake schedule for patients (11)
Tailoring the medication intake schedule to the patients’ lifestyle (12)
Encouraging patients to identify daily cues (brushing teeth) and plan medication intake
at these times (15)
Encouraging patients to use alarm devices to remember to take the medication (15)
Encouraging patients to use a 7-day pill box (5)
Encouraging patients to store spare doses of medication in different places (e.g. car,
work, purse) (9)
Encouraging patients to plan ahead for holidays and weekends (10)
Encouraging patients to organize social support (14)
Discussing general barriers to adherence and ways to overcome them (10)
Writing down patients’ dosing schedule (time, name of meds, number of pills) (13)
Using other approaches, namely
6. During consecutive visits, it was standard care that:
Yes
The healthcare provider inquired about (possible difficulties with) adherence(10)
The healthcare provider and patient determined underlying causes of non-adherence (10)
The healthcare provider and the patient generated solutions for these problems (10)
The healthcare provider inquired about side-effects. If necessary, appropriate steps were
taken (16)
The healthcare provider gave feedback about the effectiveness of the treatment using
viral load and CD4 results (6)
Feedback of MEMS-reports after a period of electronic monitoring of medication use (7)
The healthcare provider performed other actions, namely
No
?
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7. General
Yes
No
?
Patients were always given a telephone number or beeper number and were told to
contact the healthcare provider when they experienced problems with side-effects (19)
Patients were always given a telephone number or beeper number and were told to
contact the healthcare provider when they experienced problems with adherence (19)
Patients were always given a telephone number or beeper number and were told to
contact the healthcare provider if they run of out medicines (19)
Follow-up telephone calls to inquire about difficulties with the treatment (19)
Patients with adherence problems were asked to return more frequently to their
healthcare provider than patients who did not have adherence problems (21)
Social worker supports with housing, unemployment and legal issues (17)
Design a new regimen when the present regimen is too complex for the patient (18)
Delivery of medication at home (20)
8. Other aspects of standard care that were provided to your participants (e.g. adherence monitoring
and feedback, self-monitoring):
Thank you very much for completing this checklist
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Determinant
Knowledge
Coded techniques
Reference to activity in checklist
Provide general information
1
Increase memory & understanding
2
Additional channel: Brochure
3
Risk communication
4
Direct feedback of behavior
5
Feedback of clinical outcome
6
Delayed feedback of behavior
7
Persuasive communication
8
Verbal persuasion
9
Awareness
Attitude
Self-efficacy
Plan coping responses
10
Develop medication schedule
11
Tailor medication schedule
12
Medication schedule in writing
13
Use of social support
14
Intention
Action control Use of cues
15
Cope with side effects
16
Reduce environmental barriers
17
Individualize regimen
18
Continuous professional support
19
Provide materials
20
Tailoring of number of visits
21
Facilitation
NOTE: Activities coded under 7, 21, 22, 23 and 24 have been reported by individual authors,
were coded as applications of relevant behavior change techniques and therefore included in the checklist.