The problem of insufficient adherence of tuberculosis patients to treatment: causes and solutions

Authors

  • Serghei PISARENСO IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”
  • Mihaela MANEA IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”
  • Ana DONICA IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”
  • Sergiu CIOBANU IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”
  • Diana BOTNARU IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

DOI:

https://doi.org/10.52692/1857-0011.2023.3-77.03

Keywords:

tuberculosis patients, insufficient adherence to treatment, causes and solutions

Abstract

This research is dedicated to the problem of insufficient adherence of tuberculosis patients to treatment. The authors conducted a comprehensive analysis of the reasons behind this phenomenon and proposed a number of solutions to overcome it. The research is based on synthesizing the authors’ own experience, analyzing surveys of patients and doctors, as well as studying sources from various scientific citation databases. The conclusion is drawn that the insufficient adherence of tuberculosis patients to treatment is a serious problem that requires a comprehensive approach and active involvement of all parties. The findings of this work can be useful for phthisiologists, healthcare specialists, government representatives, and NGOs involved in tuberculosis issues.

Author Biographies

Serghei PISARENСO, IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

dr. hab. în șt. med., conf. univer.,

Mihaela MANEA, IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

ftiziopneumolog, m.m.s.p.,

Ana DONICA, IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

ftiziopneumolog, m.m.s.p.,

Sergiu CIOBANU, IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

ftiziopneumolog

Diana BOTNARU, IMSP Institutul de Ftiziopneumologie „Chiril Draganiuc”

ftiziopneumolog

References

Hotărâre Guvernului Republicii Moldova nr. 107 din 23 februarie 2022 Privind aprobarea Programului național de răspuns la tuberculoză pentru anii 2022-2025. https://msmps.gov.md/wp-content/uploads/2022/02/subiect-13_site.pdf

Protocolul Clinic Național „Tuberculoza la adult” PCN-123. Aprobat prin Ordinul MSMPS nr. 441 din 05.05.2020 cu privire la aprobarea protocoalelor clinice nationale. Chişinău, 2020. 155 p. https://simetb.ifp.md/Download/oficial_docs/PCN-123-2020-Tuberculoza_la_adult.pdf

Protocolul Clinic Național „Tuberculoza la copil” PCN-55. Aprobat prin Ordinul MSMPS nr. 440 din 05.05.2020 cu privire la aprobarea protocoalelor clinice nationale “Tuberculoza la copil”. Chişinău, 2020.190 p. https://simetb.ifp.md/Download/oficial_docs/PCN-55-2020-Tuberculoza_la_copil.pdf

Regulamentul cu privire la unele intervenții de creștere a aderenâei la tratamnetul antituberculos în condiâii de ambulator. Anexa nr. 1 la ordinul MS ți CNAM nr. 99/52A din 15.02.2017 https://simetb.ifp.md/Download/oficial_docs/Ordin_MS_2017_02_15_nr_99_interventii_aderenta.pdf

Dispozitia MS nr. 107-d din 27.02.2023 Cu privire la organizarea activitatilor de depistare tinta a tuberculozei si a activităților de informare, educare si suport psiho-social pentru cesterea aderentei la tratament si prevenirea recidivelor, implementate de catre organizatiile neguvernamentale. Chişinău, 2023. https://simetb.ifp.md/Download/oficial_docs/disp_ms_2023_02_27_nr_107d.pdf

Consolidated guidelines on tuberculosis. Module 4: treatment – drug-susceptible tuberculosis treatment. World Health Organization, 2022. 72 p. https://apps.who.int/iris/rest/bitstreams/1421257/retrieve

Adherence to long-term therapies. Evidence for action. World Health Organization, 2003 www.who.int/ chp/knowledge/publications/adherence_full_report.pdf

Global tuberculosis report 2022. Geneva: World Health organization, 2022. 78 p. https://apps.who.int/iris/rest/bitstreams/1474924/retrieve

Alikari V., Zyga S. Conceptual analysis of patient compliance in treatment. Health Science Journal, 2014;8(2):179-186.

Andrzejczyk A, De Geest S, Lewek P, et al. Ascertaining Barriers for Compliance: policies for safe, effective and cost-effective use of medicines in Europe Final Report of the ABC Project (Deliverable 7.1) The ABC Project team. 2012. http://abcproject.eu/img/ABC%20Final.pdf

Courtwright A., Turner A.N. (). Tuberculosis and stigmatization: pathways and interventions. Public health reports, 2010, 125(4), 34-42.

Hargreaves J.R., Boccia D., Evans C.A., Adato M., Petticrew M., Porter J.D. The social determinants of tuberculosis: from evidence to action. American journal of public health, 2011, 101(4), 654-662.

Horne R, Weinman J, Barber N, Elliott R, Morgan M. Concordance, adherence and compliance in medicine taking. UK: National Co-ordinating Centre for NHS Service Delivery and Organisation R and D; 2005, pp. 1-309.

Kruk M.E., Schwalbe N.R., Aguiar C.A. Timing of default from tuberculosis treatment: a systematic review. Tropical Medicine & International Health, 2008, 13(5), 703-712.

Kyngäs H., Duffy M.E., Kroll T. Conceptual analysis of compliance. J Clin Nurs., 2000 Jan;9(1):5-12.

Lönnroth K., Jaramillo E., Williams B.G., Dye C., Raviglione M. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Social science & medicine, 2009, 68(12), 2240-2246.

Macq J., Solis A., Martinez G., Martiny P., Dujardin B. An exploration of the social stigma of tuberculosis in five „municipios” of Nicaragua to reflect on local interventions. Health Policy, 2008, 85(1), 14-23.

Mahler-Boca B., Papahagi A., Copil I. Aderența pacientului la tratamentul TB. Curs e-learning. https://www.raa.ro/wp-content/uploads/2018/02/Curs-Elearning-Aderenta_final.pdf

Munro S.A., Lewin S.A., Smith H.J., Engel M.E., Fretheim A., Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS medicine, 2007, 4(7), e238.

Naidoo P., Peltzer K., Louw J., Matseke G., McHunu,G., Tutshana B. Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study. BMC Public Health, 2013, 13(1), 396.

Pasipanodya J.G., Gumbo T. A meta-analysis of self-administered vs directly observed therapy effect on microbiologic failure, relapse, and acquired drug resistance in tuberculosis patients. Clinical Infectious Diseases, 2013, 57(1), 21-31.

Rouillion A. Factorii abandonului şi motivaţia, Bull, Iuat, 1972, 47:68-75, pg. 45.

Self-Study Modules on Tuberculosis. Module 6: Managing Patients and Improving Adherence. CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination. Atlanta, Georgia, 2014. 98 p. https://www.cdc.gov/tb/education/ssmodules/pdfs/Modules6-508.pdf

Sbarbaro J.A. Compliance and supervision of chemotherapy of tuberculosis. Seminars in Respiratory Infections, 1995, 10(2), 108-113.

Thomas B.E., Shanmugam P., Malaisamy M., Ovung S., Suresh C., Subbaraman, R., Adinarayanan S., Nagarajan K. Psycho-socio-economic issues challenging multidrug resistant tuberculosis patients: a systematic review. PloS one, 2016, 11(1), e0147397.

Toczek A., Cox H., du Cros P., Cooke G., Ford N. Strategies for reducing treatment default in drug-resistant tuberculosis: systematic review and meta-analysis. The International Journal of Tuberculosis and Lung Disease, 2013, 17(3), 299-307.

Vilc V., Alexandru S., Crudu V., Corloteanu A., Sain D. și al. Răspunsul la epidemia de tuberculoză în Republica Moldova. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2019, nr. 3(63), pp. 28-35.

Volmink J., Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev., 2007 Oct 17;(4):CD003343.

Published

2024-01-22

Issue

Section

Research Article

Categories