Re-inventing adherence: toward a patient-centered model of care for drug-resistant tuberculosis and HIV

O’Donnell, Max R; Daftary, Amrita; Frick, Mike; Hirsch‐Moverman, Yael; Amico, K. Rivet; Senthilingam, Meera; Wolf, Allison; Metcalfe, John; Isaakidis, Petros; Davis, J. Lucian; Zelnick, Jennifer; Brust, James C.M.; Naidu, Naressa; Garretson, Marne; Bangsberg, David R.; Padayatchi, Nesri; Friedland, Gerald

doi:10.5588/ijtld.15.0360

Cited by 72 publications

(80 citation statements)

References 29 publications

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“…In South Africa where HIV diagnostic testing and capacity for drug-susceptibility testing of MTB isolates is robust, 40-80% of patients with XDR-TB are HIV infected [23,24]. In the Russian Federation and Eastern Europe, XDR-TB and HIV are often associated with injection drug use [25].…”

Section: Special Cases; Xdr-tb/hivmentioning

confidence: 99%

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Individualizing management of extensively drug-resistant tuberculosis: diagnostics, treatment, and biomarkers

Alffenaar

Akkerman

Anthony

et al. 2016

Expert Review of Anti-infective Therapy

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Introduction: Success rates for treatment of extensively drug resistant tuberculosis (XDR-TB) are low due to limited treatment options, delayed diagnosis and inadequate health care infrastructure. Areas covered: This review analyses existing programmes of prevention, diagnosis and treatment of XDR-TB. Improved diagnostic procedures and rapid molecular tests help to select appropriate drugs and dosages. Drugs dosages can be further tailored to the specific conditions of the patient based on quantitative susceptibility testing of the M. tuberculosis isolate and use of therapeutic drug monitoring. Pharmacovigilance is important for preserving activity of the novel drugs bedaquiline and delamanid. Furthermore, biomarkers of treatment response must be developed and validated to guide therapeutic decisions. Expert commentary: Given the currently poor treatment outcomes and the association of XDR-TB with HIV in endemic regions, a more patient oriented approach regarding diagnostics, drug selection and tailoring and treatment evaluation will improve treatment outcome. The different areas of expertise should be covered by a multidisciplinary team and may involve the transition of patients from hospitalized to home or community-based treatment.

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Section: Special Cases; Xdr-tb/hivmentioning

confidence: 99%

“…), regimens (TDM/MIC), multidiscplinary (psychological, social and nutritional support), and novel aspects of adherence. In situations of palliative care, safe infection control practices are of utmost importance for transitioning a patient into the community [24,54].…”

Section: Potential Role Of Host-derived Biomarkers In Treatment Guidancementioning

confidence: 99%

Individualizing management of extensively drug-resistant tuberculosis: diagnostics, treatment, and biomarkers

Alffenaar

Akkerman

Anthony

et al. 2016

Expert Review of Anti-infective Therapy

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“…For example, there are highly efficacious drugs available to treat TB (i.e., they work very well under optimized conditions). However, despite this, there are many impediments to TB elimination which are predominately “operational,” i.e., the real-world effectiveness of these efficacious drugs is reduced by a range of multi-level barriers (38, 39). Similarly, there are also now highly efficacious drugs for HCV offering the potential for a cure; however, here, the real world effectiveness of these agents is undercut by issues of cost and resultant processes that restrict access (40, 41).…”

Section: Resultsmentioning

confidence: 99%

Conceptualizing Care Continua: Lessons from HIV, Hepatitis C Virus, Tuberculosis and Implications for the Development of Improved Care and Prevention Continua

Perlman

Jordan

Nash

2017

Front. Public Health

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BackgroundTo examine the application of continuum models to tuberculosis, HIV, and other conditions; to theorize the concept of continua; and to learn lessons that could inform the development of improved care and prevention continua as public health metrics.MethodsAn analytic review of literature drawn from several fields of health care.ResultsThe continuum construct is now part of public health evaluation systems for HIV, and is increasingly used in public health and the medical literature. Issues with the comparability and optimal design of care continuum models have been raised, and their methodologic and theoretic underpinnings and scope of focus have been under-addressed. Review of relevant publications suggests that a key limitation of current models is their lack of measures reflecting incidence and mortality. Issues relating to continua data being longitudinal or cross-sectional, definition of numerators and denominators for each step, data sources, measures of timeliness of step completion, theoretic models to facilitate inferences of causes of care continuum gaps, how measures of prevention efforts, reinfection/relapses, and interactions of continua for co-occurring comorbidities should be reflected, and how analyses of differences in retention over time, across geographic regions, and in response to interventions should be conducted are critical to the development of sound care and prevention continuum models.ConclusionLessons learned from the application of continuum models to HIV and other conditions suggest that the application of well-formulated constructs of care and prevention continua, that depict, in well defined, standardized steps, incidence and mortality, along with degrees of and time to screening, engagement in care and prevention, treatment and treatment outcomes, including relapse or reinfection, may be vital tools in evaluating intervention and program outcomes, and in improving population health and population health metrics for a wide range conditions.

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“…3 Patient-centered care that incorporates counseling and support is increasingly being recognized as an approach to improve outcomes. [4][5][6] Social workers, who are often staff at hospitals and clinics that treat DR-TB patients, may be an overlooked resource.…”

mentioning

confidence: 99%

Training social workers to enhance patient-centered care for drug-resistant TB-HIV in South Africa

Zelnick

Seepamore

Daftary

et al. 2018

public health action

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KwaZulu-Natal, South Africa, is the epicenter of an epidemic of drug-resistant tuberculosis (DR-TB) and human immunodeficiency virus (HIV) co-infection, characterized by low rates of medication adherence and retention in care. Social workers may have a unique role to play in improving DR-TB-HIV outcomes. We designed, implemented and evaluated a model-based pilot training course on patient-centered care, treatment literacy in DR-TB and HIV coinfection, patient support group facilitation, and self-care. Ten social workers participated in a 1-day training course. Post-training questionnaire scores showed significant overall gains ( = 0.003). A brief training intervention may be a useful and feasible way to engage social workers in patient-centered care for DR-TB and HIV coinfection.

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Re-inventing adherence: toward a patient-centered model of care for drug-resistant tuberculosis and HIV

Cited by 72 publications

References 29 publications

Individualizing management of extensively drug-resistant tuberculosis: diagnostics, treatment, and biomarkers

Individualizing management of extensively drug-resistant tuberculosis: diagnostics, treatment, and biomarkers

Conceptualizing Care Continua: Lessons from HIV, Hepatitis C Virus, Tuberculosis and Implications for the Development of Improved Care and Prevention Continua

Training social workers to enhance patient-centered care for drug-resistant TB-HIV in South Africa

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