Non-adherence and drug-related interruptions are risk factors for delays in completion of treatment for tuberculosis.

Pettit AC, Cummins J, Kaltenbach LA, Sterling TR, Warkentin JV
Int J Tuberc Lung Dis. 2013 17 (4): 486-92

PMID: 23394818 · PMCID: PMC3981539 · DOI:10.5588/ijtld.12.0133

SETTING - A key program performance objective established by the Centers for Disease Control and Prevention (CDC) is that ≥93% of tuberculosis (TB) cases complete treatment within 12 months.

OBJECTIVE - To determine the rate of and risk factors for delay in anti-tuberculosis treatment completion.

DESIGN - Nested case-control study among TB cases reported to the Tennessee Department of Health between 1 January 2000 and 31 December 2010. Time to complete treatment was calculated using treatment start and stop dates documented in the Tuberculosis Information Management System (TIMS).

RESULTS - Of 2627 cases, 261 (9.9%) required >12 months to complete treatment. In adjusted conditional logistic regression analyses, cavitary disease and positive cultures after 2 months of therapy (OR 5.85, 95%CI 1.98-17.32, P = 0.001), non-adherence (OR 4.13, 95%CI 1.76-9.72, P < 0.001), and interruptions in treatment due to drug-related issues (OR 6.91, 95%CI 3.76-12.70, P < 0.001) were independently associated with delay in completion of TB treatment.

CONCLUSION - From 2000 to 2010, the proportion of TB cases completing treatment within 12 months increased from 84.6% to 94.9%, and remained above the CDC target during 2009-2010. Efforts to improve patient adherence and reduce interruptions in treatment due to anti-tuberculosis drug-related issues could improve the proportion of TB cases completing treatment within 12 months.

MeSH Terms (16)

Adult Antitubercular Agents Case-Control Studies Directly Observed Therapy Female Humans Logistic Models Male Medication Adherence Middle Aged Odds Ratio Program Evaluation Risk Factors Tennessee Time Factors Tuberculosis

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