Selective Directly Observed Therapy: Appraisement and Perception of Likely Participants

Smith, Albert J.E.; Moore, Lisa

doi:10.1097/00124784-199500140-00006

Cited by 2 publications

(4 citation statements)

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“…“The minute you tell them you're homeless they treat you real snobbish… They treat you like a dog down there once you get past the triage nurse…” (female TB patient, United States) [50]. …”

Section: Resultsmentioning

confidence: 99%

“…Some patients viewed direct observation negatively [22–25,40,45,48], interpreting it as distrust, and in one study describing the process as “doing time” [49]. In contrast, a study conducted with IDUs indicated that these patients appreciated the direct observation component of care because they received their treatment together with their methadone from a street nurse [50]. …”

Section: Resultsmentioning

confidence: 99%

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Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research

et al. 2007

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BackgroundTuberculosis (TB) is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence.Methods and FindingsWe searched 19 electronic databases (1966–February 2005) for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms “Tuberculosis AND (adherence OR compliance OR concordance)”. We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the themes across all studies produced a line-of-argument synthesis describing how four major factors interact to affect adherence to TB treatment: structural factors, including poverty and gender discrimination; the social context; health service factors; and personal factors. The findings of this study are limited by the quality and foci of the included studies.ConclusionsAdherence to the long course of TB treatment is a complex, dynamic phenomenon with a wide range of factors impacting on treatment-taking behaviour. Patients' adherence to their medication regimens was influenced by the interaction of a number of these factors. The findings of our review could help inform the development of patient-centred interventions and of interventions to address structural barriers to treatment adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research

et al. 2007

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“…There were instances when the information that people with TB had about the causes of the disease or the effects of the drugs used in treatment – which would affect uptake – could be considered problematic or incorrect. For example, in Smith and Moore (1995) people using methadone failed to seek treatment for TB because they believed they would be required by professionals to give up their methadone. Similarly, people who value cleanliness as a virtue may be reluctant to seek a diagnosis for TB if they believe that it is caused by poor hygiene (see Johansson et al.…”

Section: Resultsmentioning

confidence: 99%

“…These included, for example, providing ‘detox’ programmes at TB clinics and giving out food and travel vouchers to people on TB treatment (e.g. Smith & Moore 1995).…”

Section: Resultsmentioning

confidence: 99%

Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta‐synthesis

Noyes

Popay

2007

Journal of Advanced Nursing

240

158

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Selective Directly Observed Therapy: Appraisement and Perception of Likely Participants

Cited by 2 publications

References 0 publications

Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research

Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research

Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta‐synthesis

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