Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China – A Mixed Method Research Study

Xing, Wei; Zhang, Rui; Jiang, Weixi; Zhang, Ting; Pender, Michelle; Zhou, Jianchang; Pu, Jie; Liu, Shili; Geng, Wang; Chen, Yong; Jin, Li; Hu, Daiyu; Tang, Shenglan; Liu, Ying

doi:10.2147/idr.s293583

Cited by 26 publications

(34 citation statements)

References 23 publications

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“…We found that almost 20% of DS-TB patients had missed doses, which occurred most frequently, followed by a lack of follow-up sputum examination and interrupted treatment. The incidence of poor adherence was much higher in a previous study on MDR-TB patients in Chongqing [34] but lower than that in DS-TB patients reported in a previous study [25].…”

Section: Discussioncontrasting

confidence: 71%

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Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the “Integrated model”: a survey in Southwest China

Zhang

Zhou

et al. 2022

BMC Infect Dis

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Background China is one of 30 countries with a high tuberculosis (TB) burden, and poor adherence to TB treatment is one of the biggest challenges for TB control. We aimed to explore the barriers and facilitators of treatment adherence among drug-sensitive tuberculosis (DS-TB) patients under the “Integrated model” in Western China, to provide evidence-based treatment and control regimens for DS-TB patients to improve adherence behaviours. Methods Both qualitative and quantitative research methods were used to explore the factors associated with self-reported adherence (SRA) behaviours. Questionnaire surveys with DS-TB patients and in-depth interviews with leaders from the Centers for Disease Control and Prevention (CDC) and community health sectors (CHCs), healthcare workers (HCWs) from CHCs, and DS-TB patients were conducted. Results A total of 459 eligible patients were included in the quantitative survey, and two patients and 13 healthcare providers were included in the in-depth interviews. The percentage of patients who experienced a missed dose, lack of follow-up sputum examination, and interrupted treatment were 19.0%, 11.3%, and 9.2%, respectively. Patients aged 20–39 had a higher risk of missed dose [OR (95% CI): 2.302 (1.001–5.305)] and a lower risk of interrupted treatment [OR (95% CI): 0.278 (0.077–0.982)] than patients more than 60 years. Patients who were of Han ethnicity (OR [95% CI]: 0.524 [0.301–0.912]) received psychological support (OR [95% CI]: 0.379 [0.144–0.998]) from their family and had a lower risk of missed doses. Patients who had drug side effects had a higher risk of interrupted treatment (OR [95% CI]: 2.587 [1.237–5.412]). Patients who possessed higher knowledge had a lower risk of lack of follow-up sputum examination [OR (95% CI): 0.817 (0.673–0.991)]. The results of the qualitative study also reported that patients’ poor TB knowledge was the main reason for their non-SRA behaviours. Conclusions Patient-centred strategies should be implemented to improve health literacy and strengthen psychological support. More effective case management should be designed and implemented based on different patient characteristics to improve adherence behaviours in further studies.

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Section: Discussioncontrasting

confidence: 71%

“…Discontinuation of medication for two to eight consecutive weeks before restarting treatment [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

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Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the “Integrated model”: a survey in Southwest China

Zhang

Zhou

et al. 2022

BMC Infect Dis

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“…A previous study also reported drug side effects and conflicts with the timing of treatment services as the barriers to treatment adherence [ 19 ]. Another study found that poor adherence to DR-TB treatment is associated with negative side effects from the treatment, busy work schedules, and financial difficulties [ 8 ]. In patients with multidrug-resistant tuberculosis (MDR-TB), both patient and regimen were related factors associated with LTFU [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Determinant factors for loss to follow-up in drug-resistant tuberculosis patients: the importance of psycho-social and economic aspects

et al. 2021

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Background Drug-resistant tuberculosis (DR-TB) is the barrier for global TB elimination efforts with a lower treatment success rate. Loss to follow-up (LTFU) in DR-TB is a serious problem, causes mortality and morbidity for patients, and leads to wide spreading of DR-TB to their family and the wider community, as well as wasting health resources. Prevention and management of LTFU is crucial to reduce mortality, prevent further spread of DR-TB, and inhibit the development and transmission of more extensively drug-resistant strains of bacteria. A study about the factors associated with loss to follow-up is needed to develop appropriate strategies to prevent DR-TB patients become loss to follow-up. This study was conducted to identify the factors correlated with loss to follow-up in DR-TB patients, using questionnaires from the point of view of patients. Methods An observational study with a cross-sectional design was conducted. Study subjects were all DR-TB patients who have declared as treatment success and loss to follow-up from DR-TB treatment. A structured questionnaire was used to collect information by interviewing the subjects as respondents. Obtained data were analyzed potential factors correlated with loss to follow-up in DR-TB patients. Results A total of 280 subjects were included in this study. Sex, working status, income, and body mass index showed a significant difference between treatment success and loss to follow-up DR-TB patients with p-value of 0.013, 0.010, 0.007, and 0.006, respectively. In regression analysis, factors correlated with increased LTFU were negative attitude towards treatment (OR = 1.2; 95% CI = 1.1–1.3), limitation of social support (OR = 1.1; 95% CI = 1.0–1.2), dissatisfaction with health service (OR = 2.1; 95% CI = 1.5–3.0)), and limitation of economic status (OR = 1.1; 95% CI = 1.0–1.2)). Conclusions Male patients, jobless, non-regular employee, lower income, and underweight BMI were found in higher proportion in LTFU patients. Negative attitude towards treatment, limitation of social support, dissatisfaction with health service, and limitation of economic status are factors correlated with increased LTFU in DR-TB patients. Non-compliance to treatment is complex, we suggest that the involvement and support from the combination of health ministry, labor and employment ministry, and social ministry may help to resolve the complex problems of LTFU in DR-TB patients.

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“…Hasil review dari 1 artikel dengan 111 responden pada penelitian Wang et all (2019) pasien TB Multy Drug Resistant didapatkan data kepatuhan minum obat dengan metode pengukuran kepatuhan pill count hasil kepatuhan minum obat pada pasien TB MDR sebesar tidak patuh minum obat 105 (95%). Sejalan dengan penelitian yang dilakukan oleh Wei Xing et all (2021) [27] pasien yang pernah menerima pengobatan TB MDR tidak patuh pengobatan 80 (62,5%). Perlaku tidak patuh pada penelitian Wei Xing et all (2021) adalah perilaku ketidakpatuhan melewatkan satu dosis pengobatan, mengurangi asupan obat, melewatkan pemeriksaan dahak lanjutan yang disayaratkan oleh standar rejimen pengobatan, dan pengobatan yang terputus.…”

Section: B Kepatuhan Minum Obatunclassified

Gambaran Kepatuhan Minum Obat Pada Pasien TB Paru : Literature Review

Suryantari¹,

Irnawati²

2021

prosiding

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Compliance in treatment and taking Anti Tuberculosis Drugs (OAT) in pulmonary TB Patients is very necessary for consistency in increasing the success rate of treatment. Pulmonary TB Treatment must be done regularly. Otherwise, resistance to Anti Tuberculosis Drugs (OAT) will occur, the duration of taking the drug will be longer, and there will be an increase in the dose consumed. Especially, it is about an adherence to take OAT in patients with Multy-Drug Resistant (MDR) TB and TB with HIV. To find out the description of medication adherence in pulmonary TB patients and and characteristics in pulmonary TB patients. This study used a literature review design. The pill count compliance measurement method was conducted through a keyword search and used 5 articles from Google Scholar, ProQuest, and PubMed published in 2017 – 2021. From the 5 articles reviewed, the results showed that most of the respondents were male (68% or 314 respondents). The education level of most of the respondents was elementary school education (34% or 105 respondents). Most of the respondents were employed (62% or 164 respondents). Compliance with taking medication in pulmonary TB patients was 322 (70%) compliant, given intervention was 159 (92%) compliant, without intervention was 163 (56%) compliant, MDR TB non-adherent was 105 (95%), and TB with HIV 135 was (86%) complied. Compliance with taking Anti Tuberculosis Drugs (OAT) in pulmonary TB patients must be continuously improved and maintained to achieve the World Health Organization's target of increasing the success of pulmonary TB treatment consistently at results of 90%.Keywords: Compliance, Taking Medicines, TB Drugs, Pill Count, and Pulmonary TB AbstrakKepatuhan dalam pengobatan dan minum Obat Anti Tuberkulosis (OAT) pada pasien TB Paru sangat diperlukan konsistensinya dalam meningkatkan angka keberhasilan pengobatan. Pengobatan TB Paru harus dilakukan secara teratur, jika tidak akan terjadi resistensi pada Obat Anti Tuberkulosis (OAT), semakin lama durasi minum obat dan terjadi peningkatan dosis yang dikonsumsi. Terutama kepatuhan minum OAT pada pasien TB Multy Drug Resistant (MDR) dan TB dengan HIV. Mengetahui gambaran kepatuhan minum obat pada pasien TB Paru dan karakteristik pada pasien TB Paru. Desain Literature Review dengan metode pengukuran kepatuhan pill count melakukan pencarian melalui kata kunci dan menggunakan 5 artikel dari database hasil penulusuran elektronik pada Google Cendekia, ProQuest, Pubmed yang dipublish pada tahun 2017 – 2021. Dari 5 artikel yang di review di dapatkan hasil responden pada artikel sebagian besar berjenis kelamin laki – laki yaitu 314 (68%). Tingkat pendidikan responden sebagian besar berpendidikan SD yaitu 105 (34%), dan sebagian besar responden bekerja yaitu 164 (62%). Kepatuhan minum obat pada pasein TB dengan mengabaikan intervensi yang diberikan yaitu 322 (70%) patuh, diberikan intervensi 159 (92%) patuh, tanpa intervensi yang diberikan 163 (56%) patuh, TB MDR tidak patuh 105 (95%), dan TB dengan HIV 135 (86%) patuh. Kepatuhan minum Obat Anti Tuberkulosis (OAT) pada pasien TB Paru harus terus ditingkatkan dan dipertahankan untuk mencapai target World Heatlh Organisation dalam meningkatkan keberhasilan pengobatan TB Paru secara konsisten pada hasil ≥ 90%.Kata kunci: Kepatuhan; Minum Obat; Obat TB; Pill Count; dan TB Paru

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Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China – A Mixed Method Research Study

Cited by 26 publications

References 23 publications

Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the “Integrated model”: a survey in Southwest China

Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the “Integrated model”: a survey in Southwest China

Determinant factors for loss to follow-up in drug-resistant tuberculosis patients: the importance of psycho-social and economic aspects

Gambaran Kepatuhan Minum Obat Pada Pasien TB Paru : Literature Review

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