Patient and Provider Reported Reasons for Lost to Follow Up in MDRTB Treatment: A Qualitative Study from a Drug Resistant TB Centre in India

Deshmukh, Rajesh D.; Dhande, D. J.; Sachdeva, Kuldeep Singh; Sreenivas, Achuthan; Kumar, A. M. V.; Satyanarayana, Srinath; Parmar, Malik; Moonan, Patrick K.; Lo, Terrence Q.

doi:10.1371/journal.pone.0135802

Cited by 99Tuberculosis Research and EpidemiologyMedication Adherence and ComplianceHIV/AIDS Research and Interventions

Patient and Provider Reported Reasons for Lost to Follow Up in MDRTB Treatment: A Qualitative Study from a Drug Resistant TB Centre in India

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Deshmukh, Rajesh D., Dhande, D. J., Sachdeva, Kuldeep Singh, Sreenivas, Achuthan, Kumar, A. M. V., Satyanarayana, Srinath, Parmar, Malik, Moonan, Patrick K. +1 more·2015·PLOS ONE

DOI 10.1371/journal.pone.0135802PMC PMC4547708

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Abstract

INTRODUCTION: Multidrug-resistant Tuberculosis (MDR TB) is emerging public health concern globally. Lost to follow-up (LTFU) is one of the key challenge in MDRTB treatment. In 2013, 18% of MDR TB patients were reported LTFU in India. A qualitative study was conducted to obtain better understanding of both patient and provider related factors for LTFU among MDR TB treatment. METHODS: Qualitative semi-structured personal interviews were conducted with 20 MDRTB patients reported as LTFU and 10 treatment providers in seven districts linked to Nagpur Drug resistant TB Centre (DRTBC) during August 2012-February 2013. Interviews were transcribed and inductive content analysis was performed to derive emergent themes. RESULTS: We found multiple factors influencing MDR TB treatment adherence. Barriers to treatment adherence included drug side effects, a perceived lack of provider support, patient financial constraints, conflicts with the timing of treatment services, alcoholism and social stigma. CONCLUSIONS: Patient adherence to treatment is multi-factorial and involves individual patient factors, provider factors, and community factors. Addressing issue of LTFU during MDRTB treatment requires enhanced efforts towards resolving medical problems like adverse drug effects, developing short duration treatment regimens, reducing pill burden, motivational counselling, flexible timings for DOT services, social, family support for patients & improving awareness about disease.

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Many factors influence MDR-TB patients' treatment adherence: side effects of treatment, lack of support from health service providers, financial conditions, alcohol use, and social stigma.
“A qualitative study explains that many factors influence MDR-TB patients’ treatment adherence; these factors are side effects of treatment, lack of support from health service providers, financial conditions, alcohol use, and the existence of social stigma MDR-TB patients experienced.31”
From The effects of acceptance and commitment therapy on psychosocial impact and adherence of multidrug-resistant tuberculosis patients (2022) · cites this paper as [31]

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Additional file 1 of Is a differentiated care model needed for patients with TB? A cohort analysis of risk factors contributing to unfavourable outcomes among TB patients in two states in South India
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Additional file 2 of “Side effects--part of the package”: a mixed methods approach to study adverse events among patients being programmatically treated for DR-TB in Gujarat, India
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Additional file 2 of Costs incurred by patients with drug-susceptible pulmonary tuberculosis in semi-urban and rural settings of Western India
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RESEARCH ARTICLE Patient and Provider Reported Reasons for Lost to Follow Up in MDRTB Treatment: A Qualitative Study from a Drug Resistant TB
Centre In India, Deshmukh, R. D., Dh, D. J., Sachdeva, K. S., Sreenivas, A., Kumar, A. M. V., Satyanarayana, S., Parmar, M., Moonan, K., & Lo, T. Q. (2016)
Self-citation
Factors Affecting Treatment Adherence Among Persons With Multidrug-Resistant Tuberculosis (MDR-TB) in Western India: A Qualitative Exploration
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Authors: Deshmukh, R. D., Dhande, D. J., Sachdeva, K. S., Sreenivas, A., Kumar, A. M. V., Satyanarayana, S., Parmar, M., Moonan, P. K., & Lo, T. Q.
Affiliations: World Health Organization - India (IN)
NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital (IN)
Ministry of Health and Family Welfare (IN)
International Union Against Tuberculosis and Lung Disease (FR)
McGill University (CA)
Centers for Disease Control and Prevention (US)
Corresponding author: Deshmukh, Rajesh D.
ORCID: Sachdeva, Kuldeep Singh
Satyanarayana, Srinath
Parmar, Malik
Moonan, Patrick K.
Lo, Terrence Q.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2015-08-24
Volume: 10
Issue: 8
Pages: e0135802
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0135802
PMC: PMC4547708
OpenAlex: W2113382006
Cited by: 99
References: 14
Citations by year: 2026: 4 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 10 · 2021: 16 · 2020: 20 · 2019: 12 · 2018: 4 · 2017: 5 · 2016: 6
FWCI: 3.89
Type: journal article
Language: en
Open access: gold
doi.org
Licence: public-domain
creativecommons.org/publicdomain/zero/1.0/ (vor)
Locations: PLoS ONE (publishedVersion, public-domain)
Europe PMC (PubMed Central) (publishedVersion, public-domain)
PubMed Central (publishedVersion, public-domain)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: World Health Organization
Ministry of Health and Family Welfare
Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: multidrug-resistant tuberculosis, loss to follow-up, medication adherence, adverse drug reactions, alcoholism, social stigma, financial constraints, directly observed therapy, motivational counseling, family support, medication burden
MeSH terms: Adult, Female, Humans, India, Male, Middle Aged, Patient Compliance, Public Health, Tuberculosis, Multidrug-Resistant, Qualitative Research, Lost to Follow-Up, Drug-Related Side Effects and Adverse Reactions

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Patient and Provider Reported Reasons for Lost to Follow Up in MDRTB Treatment: A Qualitative Study from a Drug Resistant TB Centre in India

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