A Study on Treatment Defaulters in Tuberculosis Patients on Dots Therapy

Abstract

Tuberculosis is an infectious airborne, chronic granulomatous bacterial disease which requires a prolonged treatment to get a complete cure and prevent death, relapse, resistance to drugs and spreading it to the community. Present study was focused on treatment defaulters among tuberculosis patients receiving dots therapy. A prospective observational study was carried out in the in-patient and outpatient department of pulmonary medicine and other departments with dots referral in a hospital setting for a period of eight months from September 2017- April 2018. During the study period all the patients who was administered with dots therapy for the treatment of tuberculosis were enrolled as per the study criteria. All the patients were interviewed to know there treatment status and also monitored there ADR to check compliance with dots therapy. All the datas were analyzed using descriptive statistics. Out of 90 patients, 21 patients interrupted the treatment, of which 12 were defaulters. The overall percentage of the default to the treatment was 13.3%. The case fatality rate was 4.4%. The mean age of defaulting was found to be 53.3 years and the highest percentage were in the age group 50-65years. Male patients, rural domicile, patients pursuing primary education, pulmonary TB patients were high among the defaulters. Distance (58.3%) transportation (25%), staying alone (16.7%), workload (25%) were the general problems felt by the defaulters. 41.7% were dissatisfied with the behavior of dots provider and 50% of them did not have family support. Patients interrupted treatment in there early phases (41.7% in intensive phase and 58% in early continuous phase). The reasons to default were feeling of wellbeing after the treatment (41.7%), side effects (25.0%). Migration, non-availability of medicines, affording transport charges, medical issues were the other reasons (8.3%). Out of 90 patients, 17 (18.9%) patients came out with a total of 24 ADRs. From this only 2 patients had defaulted from the treatment due to intolerance from the medicational Side effects. ADR monitoring improved the knowledge (from 4.9 to 8.2) and treatment (1.2 to 2.5) of the patient in the current study. From the study we came to conclude that Defaulting was seen mainly due to unawareness, carelessness, disbelief of the treatment method. This can be enhanced by patient education, interviewing them periodically, Monitoring the treatment condition and side effects. So the Clinical pharmacists is responsible in promoting the dots therapy to improve the patients adherence towards it, there by achieving a well treatment outcome