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LETTER TO THE EDITOR
Year : 2022  |  Volume : 20  |  Issue : 4  |  Page : 266-267

Finding the gaps: Measuring treatment adherence in tuberculosis patients


1 Department of Community Medicine, Sri Lalithambigai Medical College and Hospital, Chennai, Tamil Nadu, India
2 Department of Community Medicine, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India
3 Department of Community Medicine, Trichy SRM Medical College and Hospital and Research Centre, Tiruchirappalli, Tamil Nadu, India

Date of Submission25-May-2022
Date of Decision29-May-2022
Date of Acceptance29-Jun-2022
Date of Web Publication17-Oct-2022

Correspondence Address:
Dr. Anugraha John
Department of Community Medicine, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_59_22

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How to cite this article:
John A, Avirneni HT, Swaminathan SS. Finding the gaps: Measuring treatment adherence in tuberculosis patients. Curr Med Issues 2022;20:266-7

How to cite this URL:
John A, Avirneni HT, Swaminathan SS. Finding the gaps: Measuring treatment adherence in tuberculosis patients. Curr Med Issues [serial online] 2022 [cited 2022 Dec 1];20:266-7. Available from: https://www.cmijournal.org/text.asp?2022/20/4/266/358647



Sir,

Globally, one of the major barriers in the control of tuberculosis (TB) is the lower levels of adherence to the treatment among TB patients, leading to varied treatment outcomes such as failure in the treatment or relapse of TB while increasing the risk of drug resistance. This in turn can lead to multidrug-resistant TB or extensively drug-resistant TB prolonging the treatment and increasing the medical expenses.[1] Treatment adherence in the context of control of TB can be defined as compliance of the patient to the prescribed treatment regimen over a recommended period. However, adherence to such therapies for usually longer periods is not just determined by a single factor, but by a multitude of factors making it multidimensional. This interplay of factors spanning across dimensions such as socioeconomic status, health-care delivery system, comorbidities, and other factors related to therapy such as side effects of the drugs and treatment response rates. Hence, understanding these factors becomes extremely critical in developing interventions that can effectively lead to good treatment outcomes among TB patients, by improving their treatment adherence along the entire duration of the treatment.[2] Although multiple strategies/interventions have been reported, a “gold standard” for measuring adherence has not been established.[3],[4] Hence, attention to the quantification of adherence needs to be emphasized and this becomes highly important in the current daily regimen with fixed drug combinations under the National Tuberculosis Elimination Program while assessing adherence behaviors. While research studies undertaken in India reported the adherence to directly observed treatment, short-course at 45%–93% among TB patients,[5],[6] there exists a potential scope for further research, in the currently executed daily regimen. Hence, it becomes essential to understand the synergies between adherence and treatment outcomes. Understanding these synergies would certainly help in developing an effective adherence intervention, leading to good treatment outcomes.

Financial support and sponsorship

This study was financially supported by the Puducherry state RNTCP OR Committee – Research grant.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Das R, Baidya S, Das JC, Kumar S. A study of adherence to DOTS regimen among pulmonary tuberculosis patients in West Tripura District. Indian J Tuberc 2015;62:74-9.  Back to cited text no. 1
    
2.
Bhattacharya T, Ray S, Biswas P, Das DK. Barriers to treatment adherence of tuberculosis patients: A qualitative study in West Bengal, India. Int J Med Sci Public Health 2018;7:7.  Back to cited text no. 2
    
3.
Vernon A, Fielding K, Savic R, Dodd L, Nahid P. The importance of adherence in tuberculosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLoS Med 2019;16:e1002884.  Back to cited text no. 3
    
4.
Central TB Division, Ministry of Health and Family Welfare. National Strategic Plan to End TB in India 2017–2025. Available from: https://tbcindia.gov.in/WriteReadData/NSP%20Draft%2020.02.2017%201.pdf [Last accessed on 2022 Apr 17].  Back to cited text no. 4
    
5.
Kulkarni P, Akarte S, Mankeshwar R, Bhawalkar J, Banerjee A, Kulkarni A. Non-adherence of new pulmonary tuberculosis patients to anti-tuberculosis treatment. Ann Med Health Sci Res 2013;3:67-74.  Back to cited text no. 5
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6.
Rai N, Kushwah SS, Singh SP, Dubey D. An assessment of treatment compliance among patients on DOTS under revised national tuberculosis control programme in district Rewa, Madhya Pradesh, India. Int J Community Med Public Health 2017;2:373-9.  Back to cited text no. 6
    




 

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