Tuberculosis and type 2 Diabetes Mellitus (TB-DM) comorbidity care: Barriers from the patients’ perspective

Arini, M.Pd . Dra. Ni Wayan; Ahmad, Riris Andono

doi:10.1016/j.enfcli.2020.06.040

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…Consistent with previous findings, this study revealed the need to improve patient knowledge as a prerequisite to ensure their compliance with health care requirements [29,30]. Hence, self-management support and patient-centered care (PCC) may support the successful TB-DM care services as it becomes the critical component in the multimorbid disease care frameworks [9,31,32]. On the other hand, our study also revealed that patients' potential cost burdens to access health services also have an impact on timely diagnosis and subsequent appropriate treatment [9].…”

Section: Discussionsupporting

confidence: 85%

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Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Arini

Sugiyo

Permana

2022

BMC Health Serv Res

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Introduction The comorbidity of tuberculosis and diabetes mellitus (TB-DM) is a looming global co-epidemic problem. Despite the Indonesian Government’s ongoing effort to impose regulation for collaborative TB-DM management, the involvement of private primary care providers (PPCs) has not been considered before the COVID-19 pandemic. This study aimed to capture the PPCs’ existing practices and explore their challenges, opportunities, and potential roles in the collaborative TB-DM services and control. Methods A descriptive qualitative research design was used to collect data. Two Focus Group Discussions (FGDs) were conducted with 13 healthcare workers (HCWs) from different private clinics and eight private/solo general practitioners (GPs) from Yogyakarta City, Indonesia. We triangulated these data with data from FGDs of HCWs community health centers (CHCs) and in-depth interviews of three regional health regulators, five hospitals staff members, and a representative of national health insurance. The discussions were audio-recorded, transcribed verbatim, and subjected to thematic analysis. Results PPCs have not been initiated into the implementation of the collaborative TB-DM programme. The themes identified in this study were health system-related barriers, knowledge and perception of HCWs, lack of implementation of bi-directional screening, and needs of multisector role. The potential roles identified for PPCs include involvement in health promotion, bi-directional screening, patient referral, and data reporting according to the TB-DM programme indicators. However, more thorough improvement of PPCs’ capacity and logistic supplies are needed to provide comprehensive TB treatment. Conclusion Although PPCs’ involvement in implementing collaborative TB-DM services has yet to be considered, their potential role should not be neglected. Therefore, it is essential to increase their involvement by enhancing their capacity and improving the Public-Private Mix. PPCs’ engagement should be initiated and maintained to ensure the sustainability of the programme.

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Section: Discussionsupporting

confidence: 85%

“…As well as being known for worsening TB outcomes and treatment failure, DM often leads to TB patients being unrecognized due to non-typical symptoms [8]. This difficulty hampers the identification of cases since it often causes delays in diagnosis in Indonesia [9]. The rising incidence of DM adds to Indonesia's double burden of diseases.…”

Section: Introductionmentioning

confidence: 99%

Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Arini

Sugiyo

Permana

2022

BMC Health Serv Res

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“…Consistent with the literature, this research revealed the need to improve patient capacity as the prerequisite of their involvement to gain their compliance in health care services [32,33]. Hence, selfmanagement support and patient-centered care (PCC) might support successful TB-DM care services as it becomes the critical components in the multimorbid disease care frameworks [9,34,35]. On the other hand, patients' burden and cost to access health services also contribute to their timely diagnosis and subsequent treatment appropriately [9].…”

Section: Discussionsupporting

confidence: 65%

“…Hence, selfmanagement support and patient-centered care (PCC) might support successful TB-DM care services as it becomes the critical components in the multimorbid disease care frameworks [9,34,35]. On the other hand, patients' burden and cost to access health services also contribute to their timely diagnosis and subsequent treatment appropriately [9]. Thus, patients' complex bio-psycho-socio-economic problems should be solved to strengthen the medical treatment approach [22,36].…”

Section: Discussionmentioning

confidence: 99%

“…As well as being known that DM worsens TB outcomes and leads to TB treatment failure, DM often causes TB patients to be unrecognized due to non-typical symptoms [8]. This di culty inhibits case nding since it often causes diagnosis delays in Indonesia [9]. Turning now to the rising incidence of DM, it adds to Indonesia's double burden of diseases.…”

Section: Introductionmentioning

confidence: 99%

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Challenges, Opportunities, and Potential Roles of the Private Primary Care in Tuberculosis and Diabetes Mellitus (TB-DM) Collaborative Care and Control: A Qualitative Study

Arini

Sugiyo

Permana

2021

Preprint

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Introduction: TB-DM is a new looming global co-epidemic problem. Despite the Indonesian Government's ongoing effort to put the collaborative TB-DM management regulation in place, it has not taken into account the involvement of private primary care (PPC). This study intended to capture the PPC's existing practices and explore their challenges, opportunities, and potential roles in the collaborative TB-DM services and control.Methods: A descriptive qualitative research design was used to collect data. Two Focus Groups Discussion (FGDs) were conducted with 13 healthcare workers (HCWs) from different private clinics and nine private general practitioners (GPs) from Yogyakarta City, Indonesia. We triangulated the data with the FGDs of HCWs community health centers (CHCs) and in-depth interviews with three regional health regulators. The discussions were audiotaped, transcribed verbatim, and subjected to thematic analysis.Results: PPCs have not been initiated to be involved in the implementation of collaborative TB-DM program. The themes obtained in this study were health system-related barriers, HCWs’ knowledge and perception, un-implemented bi-directional screening, and multisector role needs. The PPCs’ potential roles identified are to conduct health promotion, bi-directional screening, patient referring, and data reporting according to the TB-DM program indicators.Conclusion: Although its involvement in implementing collaborative TB-DM services has yet to be taken into account, the PPC's potential role should not be neglected. Therefore, it is essential to increase their involvement by enhancing their capacity and improving the Public-Private Mix. PPC engagement should be initiated and maintained to ensure the sustainability of the program.

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THE INFLUENCE OF HEALTHCARE WORKERS' SOCIAL SUPPORT ON COMPLIANCE TO MEDICATION IN MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS AT THE REGIONAL GENERAL HOSPITAL OF Dr. SAIFUL ANWAR

Adima,

Arini

2024

Clinical Epidemiology and Global Health

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Tuberculosis and type 2 Diabetes Mellitus (TB-DM) comorbidity care: Barriers from the patients’ perspective

Cited by 8 publications

References 10 publications

Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Challenges, Opportunities, and Potential Roles of the Private Primary Care in Tuberculosis and Diabetes Mellitus (TB-DM) Collaborative Care and Control: A Qualitative Study

THE INFLUENCE OF HEALTHCARE WORKERS' SOCIAL SUPPORT ON COMPLIANCE TO MEDICATION IN MULTI DRUG RESISTANT TUBERCULOSIS PATIENTS AT THE REGIONAL GENERAL HOSPITAL OF Dr. SAIFUL ANWAR

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