Perceived challenges of DRM testing: burdensome procedures
Some of the perceived challenges stated by providers and policymakers included the difficulty of complying with current complicated SOC DRM testing protocols and requirements, such as mandatory bureaucratic approvals, multidisciplinary team discussions, and patient communication. As such, some providers commented that SOC DRM testing processes are “pathetic” and have been “disappointments”. Specifically, one provider mentioned that the two-week directly observed drug ingestion trial prior to requesting the DRM test can be challenging to achieve, due to difficulty contacting, coordinating with, and monitoring of patients for adequate completion of the trial requirements. The directly observed HIV treatment period involves a trained peer, such as a healthcare provider or family member, who observes the patient ingesting prescribed ART daily, until consistent adherence-enhancing behaviors are adopted. Many providers and policymakers emphasized that the bureaucratic steps involved with ordering and conducting a test were confusing and required close monitoring by providers, making the DRM testing process difficult to complete. As a result, the burdensome DRM testing process discouraged many clinicians from ordering test in the first place.