Factors Associated with Non-Adherence to Anti-Tuberculosis Treatment Among Patients in Lahore, Pakistan

Abstract

Introduction: Tuberculosis is a major public health threat that has annihilated more of its infected subjects than any other infectious disease. This study was conducted to explore the factors of non-adherence to anti-tuberculosis treatment along with the socio-demographic indicators. The study also assessed the association between reasons for non-adherence to anti-tuberculosis treatment and the place of living of the patients. Materials and Methods: This cross-sectional study was conducted in Social Security Hospital, Lahore from September 2020 to June 2021 by interviewing 150 participants receiving anti-TB drugs for at least one month. A semi-structured questionnaire was used to collect information regarding patient’s sociodemographics and factors associated with non-adherence to anti-tuberculosis treatment. A Chi-square test was performed to find out the association between reasons for non-adherence to anti-tuberculosis treatment and place of living using SPSS. Results: Of 150 participants, 54.7% were males while 45.3% were females having age range between 18 to 80 years. The average duration of anti-tuberculosis treatment was 3.88±1.346 months. The average overall number of anti-tuberculosis treatment doses missed during the last two weeks was 3.23 ±1.495. Patients reported that the treatment course was lengthy (99.3%), took more than 15 minutes travel time to reach the health care facility (91.3 %), and felt that their appetite was influenced after taking drugs (90.7%). Patients living in rural areas (52.6%) were more likely to feel poor support from health staff as compared to those who were residing in urban areas (33.3%) which was statistically significant (p = 0.026). Conclusion: The study concluded that the level of education of the patients is associated with the non-adherence to TB treatment among people living in urban and rural areas. Also, distance of the healthcare facility from residence, travelling time, nature and availability of transport services significantly affect the patient compliance with the TB therapy. Moreover, socioeconomic background, monthly income, and employment status play an important role in the determination of successful completion of TB treatment by a patient. Whereas multiple drugs for treatment, higher dosages and long duration of treatment also affects the adherence to the treatment plan.