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Free Content Multidrug-resistant tuberculosis patients lost to follow-up: self-reported readiness to restart treatment

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SETTING: Multidrug-resistant tuberculosis (MDR-TB) patients lost to follow-up (LTFU) from Programmatic Management of Drug-resistant Tuberculosis facilities in the Philippines.

OBJECTIVES: To gain insight into patients' readiness to return to treatment.

METHODS: MDR-TB patients who initiated treatment and were categorized as LTFU were identified using TB registers, contacted, and asked to consent to an interview and medical record review. At the conclusion of the interview, patients' readiness to restart treatment was assessed and examined in relation to demographic, clinical, and interview data. Odds ratios were calculated.

RESULTS: When asked if they would consider restarting MDR-TB treatment, 3% of the 89 participating patients reported that they had already restarted, 34% indicated that they wanted to restart, 33% had not considered restarting, 28% were undecided, and 2% had decided against restarting. Patients who wanted to restart treatment were more likely to report having borrowed money for TB-related expenses (OR 5.97, 95%CI 1.27–28.18), and were less likely to report being self-employed (OR 0.08, 95%CI 0.01–0.67), or perceive themselves at low or no risk for TB relapse (OR 0.30, 95%CI 0.08–0.96) than patients who did not indicate an interest in restarting treatment.

CONCLUSIONS: Efforts to re-engage LTFU patients in care should consider financial barriers, knowledge gaps, and personal adherence challenges in patients.
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Keywords: health behavior; patient decision; patient education; readiness; stages of change

Document Type: Research Article

Affiliations: 1: Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Tropical Disease Foundation, Makati City, The Philippines 3: National Tuberculosis Control Program, Department of Health, Manila, The Philippines 4: National Center for Pulmonary Research, Lung Center of the Philippines, Quezon City, The Philippines 5: Philippine Business for Social Progress-Innovations and Multisectoral Partnership to Achieve Control of Tuberculosis Project, Manila, The Philippines 6: World Health Organization Regional Office for the Western Pacific, Manila, The Philippines 7: Advisor to the National Tuberculosis Program, Manila, The Philippines 8: US Agency for International Development, Washington DC, USA

Publication date: September 1, 2016

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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 lung health world-wide.

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