T Tupasi1, A M C G Garfin2, J M Mangan3, R Orillaza-Chi4, L C Naval1, G I Balane1, R Basilio2, A Golubkov5, E S Joson1, W-J Lew6, V Lofranco7, M Mantala8, S Pancho7, J N Sarol1, A Blumberg3, D Burt3, E V Kurbatova3. 1. Tropical Disease Foundation, Inc, Makati City, The Philippines. 2. The National Tuberculosis Control Program, Department of Health, Manila, The Philippines. 3. Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 4. Philippine Business for Social Progress-Innovations and Multisectoral Partnership to Achieve Control of Tuberculosis (IMPACT) Project, Manila, The Philippines. 5. US Agency for International Development, Washington DC, USA. 6. World Health Organization Philippines, Manila, The Philippines. 7. The National Center for Pulmonary Research, Lung Center of the Philippines, Quezon City, The Philippines. 8. Department of Health, Manila, The Philippines.
Abstract
SETTING: Patients who initiated treatment for multidrug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. OBJECTIVES: To describe patients' views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. METHODS: In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed. RESULTS: Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants. CONCLUSIONS: A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner.
SETTING: Patients who initiated treatment for multidrug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. OBJECTIVES: To describe patients' views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. METHODS: In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed. RESULTS: Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants. CONCLUSIONS: A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner.
Authors: D Falzon; E Jaramillo; H J Schünemann; M Arentz; M Bauer; J Bayona; L Blanc; J A Caminero; C L Daley; C Duncombe; C Fitzpatrick; A Gebhard; H Getahun; M Henkens; T H Holtz; J Keravec; S Keshavjee; A J Khan; R Kulier; V Leimane; C Lienhardt; C Lu; A Mariandyshev; G B Migliori; F Mirzayev; C D Mitnick; P Nunn; G Nwagboniwe; O Oxlade; D Palmero; P Pavlinac; M I Quelapio; M C Raviglione; M L Rich; S Royce; S Rüsch-Gerdes; A Salakaia; R Sarin; D Sculier; F Varaine; M Vitoria; J L Walson; F Wares; K Weyer; R A White; M Zignol Journal: Eur Respir J Date: 2011-08-04 Impact factor: 16.671
Authors: D Boccia; J Hargreaves; K Lönnroth; E Jaramillo; J Weiss; M Uplekar; J D H Porter; C A Evans Journal: Int J Tuberc Lung Dis Date: 2011-06 Impact factor: 2.373
Authors: Salla A Munro; Simon A Lewin; Helen J Smith; Mark E Engel; Atle Fretheim; Jimmy Volmink Journal: PLoS Med Date: 2007-07-24 Impact factor: 11.069
Authors: Erika Mohr; Johnny Daniels; Busisiwe Beko; Petros Isaakidis; Vivian Cox; Sarah Jane Steele; Odelia Muller; Leigh Snyman; Virginia De Azevedo; Amir Shroufi; Laura Trivino Duran; Jennifer Hughes Journal: PLoS One Date: 2017-05-18 Impact factor: 3.240
Authors: S E J van de Berg; P T Pelzer; C Mulder; S van den Hof; A J van der Land; E Abdrakhmanova; A Muhammad Ozi; M Arias; S Cook-Scalise; G Dravniece; A Gebhard; S Juneja; R Handayani; D Kappel; M Kimerling; I Koppelaar; S Malhotra; B Myrzaliev; B Nsa; J Sugiharto; N Engel Journal: BMC Public Health Date: 2021-07-16 Impact factor: 3.295