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Free Content Social support and incentives programme for patients with tuberculosis: experience from the Russian Federation

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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.
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Keywords: Russia; TB; adherence to treatment; incentives; social support

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: 2007-11-01

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  • 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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