Free Content Factors associated with treatment adherence in a randomised trial of latent tuberculosis infection treatment

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SETTING: Randomised controlled trial of latent tuberculosis infection (LTBI) treatment in 10 clinics in Canada, Saudi Arabia and Brazil.

OBJECTIVE: To identify early predictors of LTBI treatment adherence, including pre-treatment characteristics.

DESIGN: Patients randomised to 4 months of rifampicin (RMP; n = 420) or 9 months of isoniazid (n = 427) were monitored for adherence using an electronic device. Outcomes were 1) treatment completion, defined as intake of ≥80% of the prescribed doses, and further categorised as completed within the allotted time or not; and 2) treatment regularity, measured by the time interval between doses. Relative risk (RR) and adjusted odds ratios (aOR) of patients’ pre-treatment characteristics and adherence at first follow-up visit were calculated.

RESULTS: Completion of treatment was higher with RMP (aOR 4.3, 95%CI 2.7–6.8). Early predictors (first follow-up visit) of non-adherence were late first visit attendance (RR for completion in time 0.9, 95%CI 0.8–0.98), >20% of missed doses (RR 0.4, 95%CI 0.3–0.6) and greater variation of hours between doses (0.209 vs. 0.131, P < 0.001). Serious adverse events were not associated with irregularity of treatment.

CONCLUSION: The shorter RMP regimen was associated with better adherence. Patients with poor adherence could be identified at the first follow-up visit from their punctuality in follow-up, missed doses and variability of pill-taking.

Keywords: adherence; compliance; isoniazid; rifampicin; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Pró-Reitoria de Saúde, Gama Filho University, Brazil 2: Tuberculosis Program Evaluation and Research Unit, University of Alberta, Edmonton, Alberta, Canada 3: Respiratory Epidemiology & Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada 4: King Abdulaziz Medical City/King Abdulaziz Bin Saud University, Riyadh, Saudi Arabia

Publication date: May 1, 2010

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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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