Abstract
BackgroundPreviously treated tuberculosis (TB) patients are a widely reported risk factor for multidrug-resistant tuberculosis. Identifying patients’ problems during treatment is necessary to control TB, especially in a high-burden setting. We therefore explored barriers to successful TB treatment from the patients’ perspective, aiming to identify potential patient-centred care strategies to improve TB treatment outcome in Indonesia.MethodsA qualitative study was conducted in a province of Indonesia with high TB prevalence. Participants from various backgrounds (i.e., TB patients, physicians, nurses, pharmacists, TB activist, TB programmers at the district and primary care levels) were subject to in-depth interviews and focus group discussions (FGDs). All interviews and FGDs were transcribed verbatim from audio and visual recordings and the respective transcriptions were used for data analysis. Barriers were constructed by interpreting the codes’ pattern and co-occurrence. The information’s trustworthiness and credibility were established using information saturation, participant validation and triangulation approaches. Data were inductively analysed using the Atlas.ti 8.4 software and reported following the COREQ 32-items.ResultsWe interviewed 63 of the 66 pre-defined participants and identified 15 barriers. The barriers were classified into three themes, i.e., socio-demography and economy; knowledge and perception and TB treatment. Since the barriers can be interrelated, we determined five main barriers across all barrier themes, i.e., lack of TB knowledge, stigmatisation, long distance to the health facility, adverse drug reaction and loss of household income.ConclusionThe main treatment barriers can be considered to strengthen patient-centred care for TB patients in Indonesia. A multi-component approach including TB patients, healthcare providers, broad community and policy makers is required to improve TB treatment success.
Highlights
According to the World Health Organisation (WHO), tuberculosis (TB) is one of the top 10 causes of death and the leading cause of single infection [1]
Lack of back fill for daily clinical work has been the reason of three healthcare staffs in the absence of interview, while 1 TB patient could not be contacted during the research period
The in-depth interviews were conducted for 19 interviews of 19 participants, while Focus group discussions (FGD) were conducted for nine groups of 44 participants
Summary
According to the World Health Organisation (WHO), tuberculosis (TB) is one of the top 10 causes of death and the leading cause of single infection [1]. This problem has become more complex when drug-resistant TB (DR-TB) pathogens, the TB pathogens resistant to one or more anti-tuberculosis drugs, emerge in every setting. Identification of TB problems and strategies in high-prevalence countries are essential to control TB case at the global level. Identifying patients’ problems during treatment is necessary to control TB, especially in a high-burden setting. We explored barriers to successful TB treatment from the patients’ perspective, aiming to identify potential patient-centred care strategies to improve TB treatment outcome in Indonesia
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