SETTING: Tuberculosis Department, Bethania Hospital, Sialkot, Pakistan. OBJECTIVE: To determine whether intensive counselling can improve treatment adherence. DESIGN: In a randomised controlled intervention trial of 1,019 adult tuberculosis patients, 49% were assigned to the intervention group and 51% to the control group. Baseline data were obtained through semi-structured interviews. Patients were followed until the end of treatment (cure, default, referral or death). The intervention included counselling at the start of treatment and at each subsequent visit for ambulatory patients, or weekly for hospitalised patients. Counselling combined health education with strategies to strengthen patients' self-efficacy. Control group patients received the usual care. The outcome measure was treatment default. RESULTS: The default rate was 54% in the control group and 47% in the intervention group: the default risk ratio was 0.87, implying a reduction in defaulting of 13%. The impact was stronger in women, ambulatory patients, re-treatment patients, women who worked in the home, and patients who were not the main provider, those with a poor knowledge of the disease or those with a short treatment delay. CONCLUSIONS:Intensive counselling has a significant, although limited, impact on treatment adherence.
RCT Entities:
SETTING:Tuberculosis Department, Bethania Hospital, Sialkot, Pakistan. OBJECTIVE: To determine whether intensive counselling can improve treatment adherence. DESIGN: In a randomised controlled intervention trial of 1,019 adult tuberculosispatients, 49% were assigned to the intervention group and 51% to the control group. Baseline data were obtained through semi-structured interviews. Patients were followed until the end of treatment (cure, default, referral or death). The intervention included counselling at the start of treatment and at each subsequent visit for ambulatory patients, or weekly for hospitalised patients. Counselling combined health education with strategies to strengthen patients' self-efficacy. Control group patients received the usual care. The outcome measure was treatment default. RESULTS: The default rate was 54% in the control group and 47% in the intervention group: the default risk ratio was 0.87, implying a reduction in defaulting of 13%. The impact was stronger in women, ambulatory patients, re-treatment patients, women who worked in the home, and patients who were not the main provider, those with a poor knowledge of the disease or those with a short treatment delay. CONCLUSIONS: Intensive counselling has a significant, although limited, impact on treatment adherence.
Authors: Payam Nahid; Susan E Dorman; Narges Alipanah; Pennan M Barry; Jan L Brozek; Adithya Cattamanchi; Lelia H Chaisson; Richard E Chaisson; Charles L Daley; Malgosia Grzemska; Julie M Higashi; Christine S Ho; Philip C Hopewell; Salmaan A Keshavjee; Christian Lienhardt; Richard Menzies; Cynthia Merrifield; Masahiro Narita; Rick O'Brien; Charles A Peloquin; Ann Raftery; Jussi Saukkonen; H Simon Schaaf; Giovanni Sotgiu; Jeffrey R Starke; Giovanni Battista Migliori; Andrew Vernon Journal: Clin Infect Dis Date: 2016-08-10 Impact factor: 9.079
Authors: Liza E Bronner; Laura J Podewils; Annatjie Peters; Pushpakanthi Somnath; Lorna Nshuti; Martie van der Walt; Lerole David Mametja Journal: BMC Public Health Date: 2012-08-07 Impact factor: 3.295
Authors: Chanda Mulenga; David Mwakazanga; Kim Vereecken; Shepherd Khondowe; Nathan Kapata; Isdore Chola Shamputa; Herman Meulemans; Leen Rigouts Journal: BMC Public Health Date: 2010-12-07 Impact factor: 3.295