Medicine Non-Adherence: A New Viewpoint on Adherence Arising from Research Focused on Sub-Saharan Africa
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsAuthors need to look into these points for improvement of manuscript;
1) Abstract need to be refined with significant results and conclusions
2) Authors have concluded that reasons for non adherence were similar in both developed and developing world. This should be further explained with some examples and one example of water isn't sufficient.
3) What is reason of selection of most subjects from Village side? Normally there are less facilities there so definitley results can be as expected or desired?
4) Only one subject is chosen from 5 countries which is not acceptable for any prediction of results. Reasons ?
5) Only one subject chosen of age below 20 years?
6) Only one developed country UK is selected with only six volunteers so data cant be corelated technically
Comments on the Quality of English Language
English language be proofed again
Author Response
Thank you for your analysis of my paper. I have made the changes you request. I have annotated your analysis in the attached document. I trust that my responses to your analysis are satisfactory.
Author Response File: Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThe article “Medicine non-adherence: a new viewpoint on adherence arising from research in sub-Saharan Africa” is very interesting. I have following comments/suggestions,
1. The abstract is clear.
2. The introduction provides sufficient background in the topic and the aims are clear.
3. Why is the author reporting the findings almost 9 years after the interviews were held?
4. The IRB approval number is missing.
5. The results are clear.
6. The Discussion and Conclusion are in line with the results.
Author Response
Thank you for your analysis of my paper. I appreciate your encouragemetn. I have annotated your analysis in the attached document. I trust that my responses to your analysis are satisfactory.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsThe title is research in sub-Saharan Africa, but the data includes other countries. I would suggest to either retitle or to eliminate the data that is not from sub-Saharan Africa.
Watch using that and also. Do not start a sentence with the actual number, you will need to spell out.
Abstract needs significant improvement to be more reflective of the research work. Abstract contains a run on sentence. Watch using However through paper and abstract. Yet adherence is considered to be low--provide more context to this statement.
Introduction line 26 stay with adherence rather than compliance
Line 29 sentence does not make sense ?much practical research?
Line 30 a review of reviews (systematic review or narrative review)
Line 31-33 You can't conclude that the area is expanding just because there are 19000 papers. Also, just because Medline has a hit of 19000 does not mean the focus of these papers was adherence. It could be a clinical study that documented adherence as part of the study protocol. Be very careful with statements like this.
Line 40 remove However
Lines 55-57 should be moved to the discussion section
Materials and Methods
Data from 2014 -2015? delay in publishing??
Line 61, tables in appendix include zimbabwe and zambia (not in methods)
The materials and methods section needs to be expanded and more detailed to how interviews were conducted, how individuals were trained, did they all ask the same questions?? Need more details on the coding and analysis.
Line 75 Thirty and six rather than 30 and 6
LINE 85-95 needs to be in methods
Line 102 number of results? more details on number of people who performed interviews. Did anyone refuse? How were the individuals selected to interview? Translations?
107 widespread
109 remove However
Table 4 please describe in text the definition for patient agency
Line 118 how did you decide to pick the 3 patient, medicine, context
Discussion Line 137 this is hypothesis generating and I would avoid using terms such as "it seems evident"
Line 143-`145 Does this broaden the scope--what evidence to determine the 3 aspects
Line 159 this is the first mention of utensils, should it be used before?
Section 4.2 has numerous errors in grammar and has too many thats. Avoid using terms such as Having said that, Nevertheless, but also, in consideration of generally
Line 221 remove In fact
Line 236 Nineteen rather than 19
Line 244 start with Reasons for non-adherence were...
Could you add a #5 under 5.4 providing dosing spoons
Line 280 change to It may contribute to some of ....
Research limitations need to be expanded, others need to be added for example low numbers of interviews especially within certain countries. not all countries are sub-Saharan. Training of interviewers, consistencies?
Line 299-300 delete ...to that which has been gained in this research.
Line 303 stop-smoking course requiring adherence.
Line 312 either reword the Ideas for this can be found in [21} or delete. It is out of place here (why not in discussion or introduction?)
Comments on the Quality of English Language
Needs some significant improvement, Some medications in BAN versus USAN vs INN, depends on what style you want.
Author Response
Thank you for your detailed analysis of my paper. I have made the changes you request. I have annotated your analysis in the attached document. I trust that my responses to your analysis are satisfactory.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsIt is recommended to gather data of some more persons from countries where you have only one data point for better significance
Comments on the Quality of English LanguageMinor review of English language needed to refine the manuscript
Author Response
I appreciate your suggestion to gather more data, but this is no longer possible. The purpose of the research was not to reach "significance" since it is not quantitative research, but to gain qualitative insights from as wide a range of people as feasible at that time. Gathering data across so many countries was valuable in itself, I believe.
I have reviewed the English once again.
Reviewer 3 Report
Comments and Suggestions for AuthorsThank you for thoughtful consideration of the suggested changes.
Comments on the Quality of English LanguageMinor
Author Response
Thank you again for your review. I appreciate your contribution to improving the quality of the paper.