Drug Compliance in the Treatment of Leprosy

Ga, Ellard

doi:10.5935/0305-7518.19810030

Cited by 8 publications

(5 citation statements)

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“…A review of the results showed that only one-half of the prescribed dapsone was ingested. [28] With MDT, the adherence was only 70–80%. [29] However, to accelerate leprosy elimination process, recently the WHO leprosy programme and its TAG have changed dramatically their position on supervised therapy.…”

Section: Who Therapy and Its Impactmentioning

confidence: 99%

Leprosy therapy, past and present: Can we hope to eliminate it?

Prasad

Kaviarasan

2010

Indian J Dermatol

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Leprosy remains an important problem globally. Timely detection of new cases and prompt treatment with MDT continue to be the main intervention strategies. We review the various issues related to classification, treatment, drug resistance and the possible steps to eliminate the disease in the near future. The need for newer anti leprosy agents has been felt and various agents like fluroquinolones, macrolides and minocycline have all been tried in various combinations and duration. Uniform MDT in all leprosy patients might be a logical one too. Drug resistance can be identified by PCR based DNA sequence analysis which saves much time. Drugs like thalidomide analogues, pentoxifylline, selective cytokine inhibitory drugs have proved effective in controlling type-2 reaction in leprosy patients. New drugs for leprosy reactions are still needed. Far from being eliminated as a public health problem, leprosy still causes a considerable long term morbidity in both developing and developed world. New treatment and the optimal length of MDT requires further research. We need genome based technology to address the unresolved issues of transmission of M. leprae.

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Section: Who Therapy and Its Impactmentioning

confidence: 99%

Leprosy therapy, past and present: Can we hope to eliminate it?

Prasad

Kaviarasan

2010

Indian J Dermatol

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“…Many studies have found that the patient's understanding and behavior in relation to compliance are influenced by various categories of factors. 4,5,6,7,8,9 Among these, socio-economic factors are major factors contributing to noncompliance of leprosy patients.…”

Section: Introductionmentioning

confidence: 99%

Leprosy Disease in Nepal : Knowledge and Non-compliance of Patients

Chalise

2005

J Nepal Med Assoc

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Non-compliance among leprosy patients has always been a problem in Nepal. Many researches on drugcompliance has indicated that if a patient understands well about his /her disease and its treatment, he /sheis more likely to be motivated to take the whole prescribed course of treatment properly. It is widely believedthat the understanding and behavior of patients in relation to drug compliance are largely influenced bytheir socio-economic condition and level of knowledge.In order to determine the socio-economic characteristics of non-compliant leprosy patients and their level ofknowledge of leprosy disease and treatment, a non-intervention study was carried-out in Dhanusha - a highprevalent district in Nepal bordering India. A total of 57 non-compliant leprosy cases were selected usingsystematic sampling method on the basis of available clinical records and an interview-schedule was used fordata collection. The result shows that the majority of non-compliant cases were illiterate, laborers byoccupation and from poor economic class family background (73.7%).Data revealed that majority did not understand the cause of the disease and were not aware of the durationof treatment. It was interesting to note that an overwhelming majority (94.7%) were having strong beliefthat the disappearance of sign/symptoms was the only meaning of the “cure of leprosy disease”. In view ofthis, it is strongly recommended that the patient education and counseling, public/community awarenessprogram should be improved and further strengthened. A socio-economic rehabilitation program withvocational/trade training to leprosy patients or their family members should be arranged to up-lift theirsocio-economic status.Key Words: Leprosy, Patient Knowledge, Compliance.

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“…These results confirm the excellent compliance of patients in Karigiri demonstrated previously when patients were being treated with dapsone monotherapy.19 Such regularity in drug self-administration is quite exceptional; in other parts of lndia and the rest of the world it is common to find that only about a half of the prescribed treatment is actually being ingested. 20 The remarkable correlation between the self-administration ofclofazimine and dapsone by the Karigiri patients accords with the excellent acceptability of clofazimine by the patients who did not find the skin pigementation it causes unduly troublesome. It was concluded that only about 10% of the patients were probably self-administering potentially inadequate amounts of dapsone and clofazimine.…”

Section: Discussionmentioning

confidence: 86%

Clofazimine and dapsone compliance in leprosy

Ellard¹,

Pannikar²,

Jesudasan³

et al. 1988

Leprosy Review

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SummaryThe regularity with which multi bacillary patients, who were being treated with the WHO Study Group regimen in a THELEP-sponsored field trial in South India, ingested their prescribed daily clofazimine and dapsone was studied. The ingestion of clofazimine was monitored using a specially prepared fo rmulation containing minute amounts of isoniazid as an innocuous marker. Overall drug acceptability and compliance was excellent. Approximately 75% of the prescribed daily clofazimine and dapsone doses were being ingested and it was concluded that only 5% of the patients would have benefited if their treatment had been supplemented by acedapsone injections.There was however a marked correlation between the self-administration of the 2 drugs with the consequence that the patients at greatest risk of developing rifampicin resistance because of poor dapsone compliance were the very ones most unlikely to take their daily clofazimine treatment. The results obtained emphasize the importance of employing regimens containing high degrees of supervised drug administration, especially in areas where drug compliance is known to be poor.It is recommended that all multibacillary patients should be treated with a combination of rifampicin plus dapsone plus clofazimine.1 The efficiency of two such regimens is currently being evaluated in a THELEP-sponsored field trial at the Schieffelin Leprosy Research and Training Centre in Karigiri, in the North Arcot District of Tamil Nadu in South India. 2 In regimen A, supervised 600 mg doses of rifampicin and of clofazimine were given on each of 2 consecutive days once every 4 weeks. The patients were also given 100 mg tablets of dapsone for daily self administration supplemented with intramuscular injections of 225 mg diacetyldapsone (acedap sone) once every 8 weeks which release on average 3 mg dapsone daily. Regimen B was identical to that recommended by the WHO Study Group for the routine treatment of multibacillary patients, I consisting of monthly supervised doses of600 mg rifampicin and 300 mg clofazimine supplemented by daily doses of 50 mg clofazimine and 100 mg dapsone for self-administration. Treatment was to be continued for at least 2 years and until the patients became smear-negative.

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Drug Compliance in the Treatment of Leprosy

Cited by 8 publications

References 9 publications

Leprosy therapy, past and present: Can we hope to eliminate it?

Leprosy therapy, past and present: Can we hope to eliminate it?

Leprosy Disease in Nepal : Knowledge and Non-compliance of Patients

Clofazimine and dapsone compliance in leprosy

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