An Exploratory Study to Assess Factors Associated with Adherence to Dots Therapy Among Patients Reporting at Selected Dots Centers in Punjab.

Abstract

Tuberculosis is one of the leading causes of morbidity and mortality around the world. Globally, the DOTS has been recognized as the best cost-effective approach for tuberculosis control and reduction of disease burden. The persons suffering from tuberculosis have difficulty in following a long-term treatment regimen. A non-experimental research approach was adopted for the study and exploratory research design was employed to explore the factors associated with adherence to DOTS therapy among tuberculosis patients. The Convenient Sampling technique was used to select the sample. The results of study showed that majority of the respondents 70% were adhered while 30% were non adhered to DOTS treatment. The findings revealed that area of residence and satisfaction with information received from health care personnel, were associated with adherence to DOTS therapy. Moreover, accessibility of health care facility, convenient TB center opening time, confidentiality issues, health personnel behavior, psychological stress due to continuation of DOTS therapy, relief from symptoms, difficulty in taking DOTS therapy and family support had also significant relationship with adherence to DOTS therapy while waiting time, paying money, language problems, supervision, side effects and social stigma were found to be non significant factors. The patients describes difficulties they were facing as long duration of treatment, quantity of pills, side effects and interference of DOTS therapy in daily routine. Thus, it implies that still, there is need of necessary interventions to reduce and eliminate the factors leading to non adherence as well as promotion of factors leading to adherence to DOTS therapy. The national tuberculosis program was started in 1962 in India with the aim to detect cases earliest and treat them. This program is operational in most of the districts replaced by DOTS strategy. When used properly, a course of DOTS therapy cures over 80% of patients. DOTS therapy has five elements beginning with political commitment which must be accompanied by sustained improvement for case detection, standardized treatment, reliable drug supply system, periodic evaluation and measurement. 2 The qualities of diagnosis and treatment outcome in Tuberculosis had improved significantly with the introduction of DOTS. But still treatment adherence was a problem may be due to social stigma and deficient knowledge of the disease and its treatment. 3