Social support and incentives programme for patients with tuberculosis: experience from the Russian Federation
Abstract:SETTING: Tuberculosis (TB) services including social support and incentive programmes in four Russian regions (Orel, Vladimir, Belgorod Oblasts and Republic of Mari-El).
OBJECTIVES: To determine reasons for TB treatment default among non-adherent patients and to describe patient views of social support programmes and the organisation of treatment.
METHODS: Standard anonymous questionnaires were administered to new pulmonary TB patients registered for treatment.
RESULTS: A total of 87 non-adherent patients and 1302 adherent patients were interviewed. The leading reasons for treatment default given by non-adherent patients were the need to earn money (30%), alcohol use (30%) and not perceiving themselves as being sick (25%). Monetary incentives were preferred by the majority of patients (67%), followed by food/hot meals (41%) and transportation reimbursement (32%). Overall, among the proposed social support programmes, those that offered small daily incentives (23%) or a big final bonus (21%) were the most popular. The majority of patients (67%) preferred out-patient treatment.
CONCLUSION: Collaboration between TB services and social organisations and substance abuse services as well as availability of psychological testing/counselling for patients are social support modalities for improving adherence suggested by study findings. Social support should be combined with a patient-centred approach to TB treatment.
Document Type: Regular Paper
Affiliations: 1: Office of the Special Representative of the WHO Director-General in Russia, Moscow, Russian Federation 2: Research Institute of Phthisiopulmonology of the Sechenov Moscow Medical Academy, Moscow, Russian Federation 3: Serbsky Research Institute of Psychiatry, Moscow, Russian Federation 4: Samara State Medical University, Division of TB and Lung Diseases, Samara, Russian Federation
Publication date: November 1, 2007
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