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Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study.

Publication ,  Journal Article
Xing, W; Zhang, R; Jiang, W; Zhang, T; Pender, M; Zhou, J; Pu, J; Liu, S; Wang, G; Chen, Y; Li, J; Hu, D; Tang, S; Li, Y
Published in: Infect Drug Resist
2021

AIM: This paper evaluated the treatment adherence for multidrug-resistant tuberculosis (MDR-TB) and MDR-TB case management (MTCM) in Chongqing, China in order to identify factors associated with poor treatment adherence and case management. METHODS: Surveys with 132 MDR-TB patients and six in-depth interviews with health care workers (HCWs) from primary health centers (PHC), doctors from MDR-TB designated hospitals and MDR-TB patients were conducted. Surveys collected demographic and socio-economic characteristics, as well as factors associated with treatment and case management. In-depth interviews gathered information on treatment and case management experience and adherence behaviors. RESULTS: Patient surveys found the two main reasons for poor adherence were negative side-effects from the treatment and busy work schedules. In-depth interviews with key stakeholders found that self-perceived symptom improvement, negative side-effects from treatment and financial difficulties were the main reasons for poor adherence. MDR-TB patients from urban areas, who were unmarried, were female, had migrant status, and whose treatments were supervised by health care workers from primary health clinics, had poorer treatment adherence (P<0.05). Among the MDR-TB patients surveyed, 86.7% received any type of MTCM in general (received any kind of MTCM from HCWs in PHC, MDR-TB designated hospital and centers of disease control/TB dispensaries and 62.50% received MTCM from HCWs in PHC sectors). Patients from suburban areas were more likely to receive both MTCM in general (OR=6.70) and MTCM from HCWs in MDR-TB designated hospitals (OR=2.77), but female patients (OR=0.26) were less likely to receive MTCM from HCWs in PHC sectors, and patients who were not educated about MTCM by TB doctors in designated hospitals were less likely to receive MTCM in general (OR=0.14). Patients who had not been hospitalized were less likely to receive MTCM from HCWs in MDR-TB designated hospitals (OR=0.21). CONCLUSION: Stronger MTCM by HCWs in PHC sectors would improve treatment adherence among MDR-TB patients. Community-based patient-centered models of MTCM in PHC sectors and the use of digital health technology could help to improve case management and thereby improve adherence.

Duke Scholars

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Published In

Infect Drug Resist

DOI

ISSN

1178-6973

Publication Date

2021

Volume

14

Start / End Page

999 / 1012

Location

New Zealand

Related Subject Headings

  • 3202 Clinical sciences
  • 3107 Microbiology
  • 1115 Pharmacology and Pharmaceutical Sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Xing, W., Zhang, R., Jiang, W., Zhang, T., Pender, M., Zhou, J., … Li, Y. (2021). Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study. Infect Drug Resist, 14, 999–1012. https://doi.org/10.2147/IDR.S293583
Xing, Wei, Rui Zhang, Weixi Jiang, Ting Zhang, Michelle Pender, Jiani Zhou, Jie Pu, et al. “Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study.Infect Drug Resist 14 (2021): 999–1012. https://doi.org/10.2147/IDR.S293583.
Xing W, Zhang R, Jiang W, Zhang T, Pender M, Zhou J, et al. Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study. Infect Drug Resist. 2021;14:999–1012.
Xing, Wei, et al. “Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study.Infect Drug Resist, vol. 14, 2021, pp. 999–1012. Pubmed, doi:10.2147/IDR.S293583.
Xing W, Zhang R, Jiang W, Zhang T, Pender M, Zhou J, Pu J, Liu S, Wang G, Chen Y, Li J, Hu D, Tang S, Li Y. Adherence to Multidrug Resistant Tuberculosis Treatment and Case Management in Chongqing, China - A Mixed Method Research Study. Infect Drug Resist. 2021;14:999–1012.

Published In

Infect Drug Resist

DOI

ISSN

1178-6973

Publication Date

2021

Volume

14

Start / End Page

999 / 1012

Location

New Zealand

Related Subject Headings

  • 3202 Clinical sciences
  • 3107 Microbiology
  • 1115 Pharmacology and Pharmaceutical Sciences
  • 1103 Clinical Sciences