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Free Content High rate of non-compliance with anti-tuberculosis treatment despite a retrieval system: a call for implementation of directly observed therapy in Saudi Arabia

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SETTING: Taif Chest Hospital, Taif, Saudi Arabia.

OBJECTIVES: Non-compliance with anti-tuberculosis drug therapy is recognised as a major cause of treatment failure, drug resistance and relapse. In Saudi Arabia, the problem of non-compliance is frequent and has serious implications which need urgent attention from the health-care authority. The objectives of this study were to define factors that affect compliance rate and to determine the appropriate methods to modify these factors.

DESIGN: We designed and tested a retrieval system to improve patient return for follow-up and drug collection after an initial hospital admission period in a large chest hospital in the western region of the country.

RESULTS: Of 628 patients, 358 (57%) did not attend the first out-patient clinic visit. The retrieval system was successful in bringing back only 83 patients, reducing the default rate by only 13.2%. Various factors that may affect compliance were analysed in the remaining 275 (43.8%) non-compliant patients.

CONCLUSION: Because many of these factors are difficult to change, we strongly support implementation of the WHO-recommended directly observed treatment (DOT) strategy in Saudi Arabia and other countries facing similar problems with tuberculosis control.

Keywords: compliance; control programme; observed therapy; retrieval system; tuberculosis

Document Type: Regular Paper

Affiliations: 1: King Saud University Medical College, Riyadh, Saudi Arabia 2: Taif Chest Hospital, Taif, Saudi Arabia

Publication date: 2000-04-01

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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