Perceived benefits of DRM testing: informs clinical decision-making
Providers/policymakers and patients stressed that DRM testing and DRM testing counseling were valuable to providers for optimal clinical decision-making and participants for reassurance, respectively. Study patients who had undergone DRM testing reported that the DRM testing results and counseling from the providers gave them helpful guidance or “a way forward” for next steps in their ART management. Specifically, DRM testing counseling provided patients with feedback on their adherence patterns and determined whether they needed a change in their ART regimen. As for providers, DRM testing results were crucial pieces of information that informed the clinical decision-making processes. One policymaker mentioned that clinical decisions were made easier with DRM testing because DRM testing provided insights into past antiretroviral (ARV) drug exposure for those few patients who, for whatever reasons, did not have prior ARV drug histories documented in their records. In such cases, providers felt empowered to determine appropriate treatment regimens, guided by actual information rather than blindly making a regimen change. Apart from their opinion that DRM testing aided clinical decision-making, providers and policymakers also appreciated the collaborative nature of the multidisciplinary discussions that occurred as part of the CMC meetings. Providers and policymakers stressed the importance of not having a single provider establish a patient’s treatment plan. Rather, collaborating on a team of varied and experienced staff boosted their confidence in the decisions made, especially for ART regimen changes.