Tuberculosis Treatment Adherence Research Articles

Assessing private provider perceptions and the acceptability of video observed treatment technology for tuberculosis treatment adherence in three cities across Viet Nam.

The World Health Organization recently recommended Video Observed Therapy (VOT) as one option for monitoring tuberculosis (TB) treatment adherence. There is evidence that private sector TB treatment has substandard treatment follow-up, which could be improved using VOT. However, acceptability of VOT in the private sector has not yet been evaluated. We conducted a cross-sectional survey employing a theoretical framework for healthcare intervention acceptability to measure private provider perceptions of VOT across seven constructs in three cities of Viet Nam: Ha Noi, Ho Chi Minh City, and Hai Phong. We investigated the differences in private providers' attitudes and perceptions of VOT using mixed ordinal models to test for significant differences in responses between groups of providers stratified by their willingness to use VOT. A total of 79 private providers completed the survey. Sixty-two providers (75%) indicated they would use VOT if given the opportunity. Between private providers who would and would not use VOT, there were statistically significant differences (p≤0.001) in the providers' beliefs that VOT would help identify side effects faster and in their confidence to monitor treatment and provide differentiated care with VOT. There were also significant differences in providers' beliefs that VOT would save them time and money, address problems faced by their patients, benefit their practice and patients, and be relevant for all their patients. Private providers who completed the survey have positive views towards using VOT and specific subpopulations acknowledge the value of integrating VOT into their practice. Future VOT implementation in the private sector should focus on emphasizing the benefits and relevance of VOT during recruitment and provide programmatic support for implementing differentiated care with the technology.

Preference of inhalants over pills/injections among pulmonary tuberculosis patients in Western India: A cross-sectional study

BackgroundPresently, pills and injections are the two modes of therapeutic treatment available for tuberculosis (TB) patients. Many researchers have hypothesized inhalation drug delivery for reducing treatment times and possibly limiting the insurgence of drug resistance. This study was aimed at identifying and assessing the preferences of inhalation therapy over injections/pills among pulmonary TB patients. MethodCross-sectional study design was used and a sample of 477 participants were recruited at selected three Directly Observed Treatment Short-Course (DOTS) centers in Bhiwandi city. Data was collected through self-reported questionnaire. Descriptive statistics were reported, and binomial regression models were applied for data analysis. ResultsThe preference of inhalants over pills/injections among pulmonary TB patients was significantly associated with clinical characteristics. The patients who underwent treatment for more than 1 year were 1.7 times more likely to prefer inhalants over pills/injections when compared with treatment duration of less than 1 year. Similarly, patients taking five or more pills/day were 1.7 times more likely to prefer inhalants over pills/injections when compared with patients taking 1–4 pills per day. ConclusionThe study results signify that inhalants could be an acceptable method of drug delivery in this population of TB patients. Diverse drug delivery options for TB patients may greatly contribute towards TB treatment adherence.

The Impact of COVID-19 on Tuberculosis Patients' Behavior of Seeking Medical Care - China, 2020.

What is already known on this topic? The coronavirus disease 2019 (COVID-19) pandemic has disrupted the tuberculosis (TB) service system. However, the impact on TB patients in China remains unknown. What is added by this report? This report firstly addressed the impact of COVID-19 on TB patients in China. About half of TB patients did not revisit the hospital due to personal reasons. The reasons for irregular medication and postponing or cancelling examination after full treatment course were different. What are the implications for public health practice? Health education and risk communication should be strengthened for better TB patient management and treatment adherence, especially in light of the COVID-19 pandemic.

Impact of integrating mental health services within existing tuberculosis treatment facilities.

Introduction:Depression and anxiety among tuberculosis (TB) patients can adversely affect TB treatment adherence and completion.Aim:We studied whether integrating mental health services into existing TB treatment programs would reduce symptoms of depression and anxiety and improve treatment completion among patients with drug-susceptible TB.Methods:Integrated practice units (IPUs) for TB and mental health were established within six existing TB treatment facilities in Karachi, Pakistan. Patients were screened for depression and anxiety and, if symptomatic, offered a mental health intervention consisting of at least four counseling sessions. We measured changes in reported levels of depression and anxiety symptoms from baseline following completion of counseling sessions, and rates of TB treatment completion.Results:Between February 2017 and June 2018, 3500 TB patients were screened for depression and anxiety. 1057 (30.2%) symptomatic patients received a baseline adherence session. 1012 enrolled for a mental health intervention received at least 1 counseling session. 522 (51.5%) reported no symptoms after four to six sessions. Symptomatic patients who completed at least four counseling sessions had higher rates of TB treatment completion than those who did not (92.9% vs 75.1%; p < 0.0001).Conclusion:Mental health interventions integrated within TB programs can help reduce symptoms of depression and anxiety and improve TB treatment completion.

COVID-19 and Tuberculosis-Related Catastrophic Costs.

.The COVID-19 pandemic has created an unprecedented health crisis and a substantial socioeconomic impact. It also affects tuberculosis (TB) control severely worldwide. Interruptions of many TB control programs because of the COVID-19 pandemic could result in significant setbacks. One of the targets that can be affected is the WHO’s End TB Strategy goal to eliminate catastrophic costs of TB-affected households by 2030. Disruptions to TB programs and healthcare services due to COVID-19 could potentially prolong diagnostic delays and worsen TB treatment adherence and outcomes. The economic recession caused by the pandemic could significantly impact household financial capacity because of the reduction of income and the rise in unemployment rates. All of these factors increase the risk of TB incidence and the gravity of economic impact on TB-affected households, and hamper efforts to eliminate catastrophic costs and control TB. Therefore, efforts to eliminate the incidence of TB-affected households facing catastrophic costs will be very challenging. Because financial constraint plays a significant role in TB control, the improvement of health and social protection systems is critical. Even before the pandemic, many TB–high-burden countries (HBCs) lacked robust health and social protection systems. These challenges highlight the substantial need for a more robust engagement of patients and civil society organizations and international support in addressing the consequences of COVID-19 on the control of TB.

Impact of a tuberculosis treatment adherence intervention versus usual care on treatment completion rates: results of a pragmatic cluster randomized controlled trial

BackgroundWith the global shortage of skilled health workers estimated at 7.2 million, outpatient tuberculosis (TB) care is commonly task-shifted to lay health workers (LHWs) in many low- and middle-income countries where the shortages are greatest. While shown to improve access to care and some health outcomes including TB treatment outcomes, lack of training and supervision limit the effectiveness of LHW programs. Our objective was to refine and evaluate an intervention designed to address common causes of non-adherence to TB treatment and LHW knowledge and skills training needs.MethodsWe employed a pragmatic cluster randomized controlled trial. Participants included 103 health centres (HCs) providing TB care in four districts in Malawi, randomized 1:1 stratified by district and HC funding (Ministry of Health, non-Ministry funded). At intervention HCs, a TB treatment adherence intervention was implemented using educational outreach, a point-of-care reminder tool, and a peer support network. Clusters in the control arm provided usual care. The primary outcome was the proportion of patients with successful TB treatment (i.e., cure or treatment completion). We used a generalized linear mixed model, with district as a fixed effect and HC as a random effect, to compare proportions of patients with treatment success, among the trial arms, with adjustment for baseline differences.ResultsWe randomized 51 HCs to the intervention group and 52 HCs to the control group. Four intervention and six control HCs accrued no eligible patients, and 371 of 1169 patients had missing outcome, HC, or demographic data, which left 74 HCs and 798 patients for analysis. Randomization group was not related to missing outcome, however, district, age, and TB type were significantly related and included in the primary analysis model. Among the 1153 patients with HC and demographic data, 297/605 (49%) and 348/548 (64%) in the intervention and control arms, respectively, had treatment success. The intervention had no significant effect on treatment success (adjusted odds ratio 1.35 [95% confidence interval 0.93–1.98]).ConclusionWe found no significant effect of the intervention on TB treatment outcomes with high variability in implementation quality, highlighting important challenges to both scale-up and sustainability.Trial registrationClinicalTrials.gov NCT02533089. Registered August 20, 2015.

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Tuberculosis treatment adherence in homeless population: an overview and policy dialogue

Objective: we conducted an overview of systematic reviews aiming to describe the existing interventions to increase the adherence to the TB’s treatment by homeless people. Methods: The effects and local applicability of these interventions in Brazil were obtained in a policy dialogue with stakeholders. Results: Four interventions were effective: Financial incentives; Housing; Case management Programs; Assertive community treatment. Conclusion: It is recommended to combine all interventions to achieve effectiveness.

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Adherence to Anti-Tuberculosis Treatment Among Pediatric Patients at Nekemte Specialized Hospital, Western Ethiopia.

BackgroundNon-adherence to tuberculosis treatment is the most challenging and hindering factor for successful tuberculosis therapy. The long duration of tuberculosis treatment and the undesirable effects of anti-tuberculosis drugs result in non-adherence to treatment among pediatric patients. Hence, this study was aimed to evaluate pediatrics adherence status among tuberculosis pediatric patients on anti-tuberculosis treatment at Nekemte Specialized Hospital.MethodsA health facility-based cross-sectional study design was used to recruit pediatric TB patients who were receiving their treatment between February 15 and March 15, 2019. Adherence to tuberculosis therapy was evaluated using data obtained from face-to-face interviews of their respective caregivers. The collected data were entered into EPI-manager 4.0.2 software and analyzed using SPSS version 24. Logistic regression was used to analyze the variables and variables with p-value <0.05 had a statistically significant association with the adherence to anti TB treatment.ResultsAmong 202 participants involved in the study, 120 (59.4%) of them were males and 119 (58.9%) were in the age category of 11–15 years. A total of 166 (82.2%) of the patients had extra-pulmonary tuberculosis and 174 (86.1%) of them were in the intensive phase. Of the pediatric tuberculosis patients, 48 (73.3%) of them have adhered to the treatment regimen. Female gender [AOR: 3.3, 95% CI: 1.52–7.2], younger age (0–5 years) [AOR: 5.96 95% CI: 1.81–19.6], living in urban area [AOR: 3.73, 95% CI: 1.67–8.36], and patients who did not experience side effect [AOR: 2.87, 95% CI: 1.41–5.81] were predictors of good adherence to tuberculosis treatment up on multivariable logistic regression analysis.ConclusionThe level of adherence observed in our study area was low. Age, sex, residence, and side effect experience showed an association with tuberculosis treatment adherence. Therefore, health care providers should educate all patients with tuberculosis before the initiation of anti-tuberculosis treatment.

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Relationship of The Family Health Task Implementation with Motivation and Adherence of Tuberculosis Treatment among Tuberculosis Patients

Choice‐Based Reminder Cues: Findings From an mHealth Study to Improve Tuberculosis (TB) Treatment Adherence Among the Urban Poor in India

Poor treatment outcomes due to nonadherence and consequent high levels of drug resistance continue to challenge efforts to combat tuberculosis (TB) in India. Mobile health‐ or mHealth‐based reminder cues have been considered in multiple health behavior modification interventions, including TB treatment nonadherence. We conducted a quasi‐experimental study in Ahmedabad, India, to examine the effectiveness of mHealth‐based reminder cues customized to meet diverse patient needs. Results from this experiment indicate that the potential of customized mHealth reminder cues may remain unrealized unless addressed in conjunction with the multifaceted drivers of TB treatment nonadherence. The perspective we present here has broad relevance for future mHealth studies, especially in interpreting challenges that arise within resource‐scarce settings of the urban poor and prevent them from adhering to recommended TB treatment regimens.

Percepção da enfermagem sobre a adesão e o abandono do tratamento da tuberculose

Objetivo: conhecer a percepção da enfermagem sobre os fatores envolvidos na adesão e no abandono do tratamento da tuberculose. Método: estudo qualitativo, descritivo-exploratório realizado no Centro de Referência em Tuberculose no município de Porto Alegre no Rio Grande do Sul. Nove profissionais da enfermagem responderam à entrevista semiestruturada e foi realizada a análise de conteúdo de Bardin. Resultados: identificou-se quatro categorias temáticas: a organização do serviço e o papel da enfermagem no processo de trabalho; a raiz social da tuberculose; a consulta de enfermagem como artifício para o fortalecimento da adesão ao tratamento; rede de serviços como estratégia para reduzir o abandono do tratamento. Conclusão: os profissionais de enfermagem reconhecem sua responsabilidade na adesão ao tratamento da tuberculose e percebem no cotidiano de trabalho os fatores que influenciam o abandono. Reconhecem a necessidade de um trabalho em rede, intersetorial e de proteção social para o controle da doença.

Analisis Faktor Kepatuhan Berobat Penderita Tuberculosis Paru di Bandung

&#x0D; &#x0D; &#x0D; &#x0D; ABSTRACT&#x0D; Tuberculosis (TB) is one of the public health problems that cannot be overcome. The problem is caused by several factors, one of which is the non-compliance of patients with treatment. In Indonesia, the incidence of TB cases is 842,000 per year and notification of TB cases is 569,899 cases, so there are still around 32% of the cases that have not been verified either unreached, undetected or not reported. From this incident rate the TB burden is calculated in each province and district / city, (Indonesia, 2019). Purpose: Identify factors related to adherence to the treatment of pulmonary TB patients in the working area of ​​Garuda Bandung Puskesmas. Method: This is an analytic case study with a case control design. The sample of this study was 43 pulmonary TB patients taken in total who failed and were removed from treatment in 2017. The research instrument used a questionnaire. Data analysis using chi square. Results: The most dominant factors affecting adherence to treatment among pulmonary TB patients were Gender P value (0.014) and occupational Pvalue (0.025) where p &lt;0.05 while factors not related to medication adherence were age, knowledge, education, and family income, p&gt; 0.05. Conclusion: Gender and occupation have a significant relationship to tuberculosis treatment adherence, while age, knowledge and family income have no significant relationship to tuberculosis patient adherence.&#x0D; Keywords: Pulmonary tuberculosis, compliance, Medicine &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Knowledge, Attitudes and Practices of Patients Diagnosed with Tuberculosis Related to Tuberculosis Treatment Adherence in Keetmanshoop District, Namibia

A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Public Health.

Dukungan keluarga sebagai faktor penting dalam kepatuhan minum obat pada pasien tuberkulosis paru

Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis, which can attack various organs, especially the lungs. TB treatment can be given in 2 stages, the intensive phase 2 months of treatment and the next stage 4-6 months later. Non-adherence of TB patients to treatment at a health care facility regularly becomes an obstacle in achieving recovery and may increase the risk of morbidity, mortality, and drug resistance in both TB patients and the wider community. WHO applies the Direct Observed Treatment Short Course (DOTS) strategy in the management of TB patients to ensure that patients swallow the drug under direct supervision by a Drug Supervisor (PMO). In this case the family can act as a PMO and provide support to TB patients so that it can be an important factor in tuberculosis treatment adherence. Several studies have found a relationship of family social support and medication adherence. The family needs to provide positive support to involve the family as a supporter of treatment so that there is cooperation in monitoring the treatment between the officers and family members who are sick.

Requiring smartphone ownership for mHealth interventions: who could be left out?

BackgroundMobile health (mHealth) interventions have the potential to improve health through patient education and provider engagement while increasing efficiency and lowering costs. This raises the question of whether disparities in access to mobile technology could accentuate disparities in mHealth mediated care. This study addresses whether programs planning to implement mHealth interventions risk creating or perpetuating health disparities based on inequalities in smartphone ownership.MethodsVideo Directly Observed Therapy (VDOT) is an mHealth intervention for monitoring tuberculosis (TB) treatment adherence through videos sent by patients to their healthcare provider using smartphones. We conducted secondary analyses of data from a single-arm trial of VDOT for TB treatment monitoring by San Diego, San Francisco, and New York City health departments. Baseline and follow-up treatment interviews were used to assess participant smartphone ownership, sociodemographics and TB treatment perceptions. Univariate and multivariable logistic regression analyses were used to identify correlates of smartphone ownership.ResultsOf the 151 participants enrolled, mean age was 41 years (range: 18–87 years) and 41.1% were female. Participants mostly identified as Asian (45.0%) or Hispanic/Latino (29.8%); 57.8% had at most a high school education. At baseline, 30.4% did not own a smartphone, which was similar across sites. Older participants (adjusted odds ratio [AOR] = 1.09 per year, 95% confidence interval [CI]: 1.05–1.12), males (AOR = 2.86, 95% CI: 1.04–7.86), participants having at most a high school education (AOR = 4.48, 95% CI: 1.57–12.80), and those with an annual income below $10,000 (AOR = 3.06, 95% CI: 1.19, 7.89) had higher odds of not owning a smartphone.ConclusionsApproximately one-third of TB patients in three large United States of America (USA) cities lacked smartphones prior to the study. Patients who were older, male, less educated, or had lower annual income were less likely to own smartphones and could be denied access to mHealth interventions if personal smartphone ownership is required.

Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study

ObjectivesTo understand the challenges faced by patients with tuberculosis (TB) and factors that influence TB treatment adherence in Ukraine.DesignQualitative study.SettingTB treatment facilities in Kyiv Oblast, Ukraine.ParticipantsSixty adults who had undergone...

Assessment of Factors Contributing to TB Treatment Adherence among Patients on TB Treatment in Kano State, Nigeria: A Case Study

Background: The WHO recommended DOTS has been proven to be very effective in the treatment of tuberculosis (TB) patients. However, despite its effectiveness, non-adherence to the treatment regimen remains a major concern in TB management. This has great consequences which include persistent infectiousness, higher rates of treatment failure, continued transmission, drug resistance, and untimely death. The aim of this study is to examine the factors and behavioural patterns that contribute to treatment adherence among TB patients in Kano State, Nigeria. Methods: A qualitative study design which included two focus group discussions (FGDs) and four key informant interviews (KIIs) were adopted for this study. In total, 20 participants were interviewed comprising 16 focus group discussion participants (8 patients on treatment and 8 individuals who have been cured) divided into two groups and four key informant interviews with 4 health workers in the selected treatment facilities. Data analysis was done by translating and transcribing the responses from the FGDs and KIIs. The transcribed data was analysed using a thematic framework procedure. Results: It was observed that having a good treatment supporter who was effective and very supportive was the most important factor contributing to treatment adherence. Other identified factors that contributed to treatment adherence included: good communication by health personnel, social support from relatives and communities, little or no side effects from drug usage, low cost of transportation to the health facilities, a positive mind set towards drug usage and treatment, support and motivation from health workers, feelings of wellness during treatment, and a balanced diet. All the respondents agreed that treatment adherence had far reaching effects on positive treatment outcomes. Conclusion: For better treatment adherence, a competent treatment supporter should be available for TB patients. Health care workers should ensure that effective communication and a cordial relationship do exist with TB patients. Also, TB patients should be properly counselled before the commencement of their treatment regimen to help them maintain a positive mind-set towards treatment. Finally, TB interventions should provide adequate social support for patients.

The Use of Health Technology to Enhance the Adherence of Tuberculosis Treatment: A Systematic Review

Introduction: Disobedience in the context of TB treatment is one of the major problems around the world. Many efforts have been made to improve the adherence to TB treatment; one of them is the utilization of health technology such as digital technology. The aim of the study was to identify the effectiveness of the use of health technology such as digital technology to improve treatment compliance.Methods: The literature review was used to identify the interventions and then the identification of the relevant literature was done by topic and title, obtaining the literature in full text form. The analysis of the results was drawn from the many interventions in the literature. There were 15 articles found from the systematic search performed in the Scopus, Proquest, Science direct, Spingerlink and Sage databases with an RCTs design. This was conducting by entering the keywords of adherence, promoting adherence, improving adherence, tuberculosis treatment, chronic disease, health technology, digital technology, mhealth and self-reminders.Results: The search was limited to journals from 2013 to 2018, with the inclusion criteria being the use health technology such as digital technology to improve the adherence to chronic disease treatment (TB treatment).Conclusion: There are several uses of health technology when it comes to improving the adherence to TB treatment that can be used as a promotive and preventive effort during the treatment of TB.