R D Deshmukh1, D J Dhande2, K S Sachdeva3, A N Sreenivas4, A M V Kumar5, M Parmar4. 1. WHO Country Office for India, New Delhi, India; National AIDS Control Organisation, Ministry of Health and Family Welfare, New Delhi, India. Electronic address: deshmukhr@rntcp.org. 2. DR TB Centre NKPS and LMH Nagpur, Maharashtra, India. 3. National AIDS Control Organisation, Ministry of Health and Family Welfare, New Delhi, India. 4. WHO Country Office for India, New Delhi, India. 5. International Union against Tuberculosis and Lung Disease, South East Asia Office, New Delhi, India.
Abstract
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is emerging as a major public health problem globally. Treatment success rates in MDR-TB across the globe are not encouraging as completing MDR-TB treatment successfully is challenging due to high proportion of lost to follow up. METHODS: Using qualitative methods and grounded theory approach, in-depth interviews were conducted with MDR-TB patients and treatment providers. The social cognitive framework was explored as a way to guide understanding of the factors affecting treatment adherence among MDR-TB patients. RESULTS: Multiple factors influenced patient's decision to adhere to MDR-TB treatment. Self-motivation, awareness about disease and treatment, counselling support, family support, nutritional support and social support were important drivers for successful treatment. Providers related that motivational counselling, nutritional support, family support and social support encouraged treatment adherence. CONCLUSION: To improve MDR-TB treatment adherence, a patient-centric approach should be considered at the programmatic level. There is a need to formulate strategy that includes motivational counselling, nutritional supplementation and social support mobilisation for treatment adherence. Participants suggested a Patient Support Group led treatment care model for better adherence and treatment success rates in MDR-TB treatment.
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is emerging as a major public health problem globally. Treatment success rates in MDR-TB across the globe are not encouraging as completing MDR-TB treatment successfully is challenging due to high proportion of lost to follow up. METHODS: Using qualitative methods and grounded theory approach, in-depth interviews were conducted with MDR-TB patients and treatment providers. The social cognitive framework was explored as a way to guide understanding of the factors affecting treatment adherence among MDR-TB patients. RESULTS: Multiple factors influenced patient's decision to adhere to MDR-TB treatment. Self-motivation, awareness about disease and treatment, counselling support, family support, nutritional support and social support were important drivers for successful treatment. Providers related that motivational counselling, nutritional support, family support and social support encouraged treatment adherence. CONCLUSION: To improve MDR-TB treatment adherence, a patient-centric approach should be considered at the programmatic level. There is a need to formulate strategy that includes motivational counselling, nutritional supplementation and social support mobilisation for treatment adherence. Participants suggested a Patient Support Group led treatment care model for better adherence and treatment success rates in MDR-TB treatment.
Authors: Holly A Taylor; David W Dowdy; Alexandra R Searle; Andrea L Stennett; Vadim Dukhanin; Alice A Zwerling; Maria W Merritt Journal: SSM Qual Res Health Date: 2022-01-28
Authors: Angella Musiimenta; Wilson Tumuhimbise; Esther C Atukunda; Aaron T Mugaba; Conrad Muzoora; Mari Armstrong-Hough; David Bangsberg; J Lucian Davis; Jessica E Haberer Journal: Tuberc Res Treat Date: 2020-01-07