“When Treatment Is More Challenging than the Disease”: A Qualitative Study of MDR-TB Patient Retention

Citation: Shringarpure KS, Isaakidis P, Sagili KD, Baxi RK, Das M, Daftary A (2016) “When Treatment Is More Challenging than the Disease”: A Qualitative Study of MDR-TB Patient Retention. PLoS ONE 11(3): e0150849. doi:10.1371/journal.pone.0150849
Published: March 9, 2016

Abstract
India_GJ.svgBackground: One-fifth of the patients on multidrug-resistant tuberculosis treatment at the Drug-Resistant-TB (DR-TB) Site in Gujarat are lost-to-follow-up(LFU).
Objective: To understand patients’ and providers' perspectives on reasons for LFU and their suggestions to improve retention-in-care.
Design: Qualitative study conducted between December 2013-March 2014, including in-depth interviews with LFU patients and DOT-providers, and a focus group discussion with DR-TB site supervisors. A thematic-network analysis approach was utilised.
Results: Three sub-themes emerged: (i) Struggle with prolonged treatment; (ii) Strive against stigma and toward support; (iii) Divergent perceptions and practices. Daily injections, pill burden, DOT, migratory work, social problems, prior TB treatment, and adverse drugs effects were reported as major barriers to treatment adherence and retention-in-care by patients and providers. Some providers felt that despite their best efforts, LFU patients remain. Patient movements between private practitioners and traditional healers further influenced LFU.
Conclusion: The study points to a need for repeated patient counselling and education, improved co-ordination between various tiers of providers engaged in DR-TB care, collaboration between the public, private and traditional practitioners, and promotion of social and economic support to help patients adhere to MDR-TB treatment and avoid LFU.

...

Log in or register for free to continue reading
Register Now For Free Already Registered? Log In
This entry was posted in Infectious Disease and tagged .

One Comment

  1. kr john
    Posted Apr 2016 at 1:37 pm | Permalink

    Great work
    may be we should do this at the district level with larger no of patients

Post a Comment

You must be logged in to post a comment.