Latent TB Infection: Treatment Adherence

Latent TB Infection: Guide for Diagnosis and Treatment

Treatment

Adherence

Barriers to Patient Adherence

Many variables affect a patient’s adherence to the medication regimen for treatment of LTBI. Episodes of nonadherence should be recognized and addressed as soon as possible. Some examples of barriers to adherence are noted in the section that follows.

Office-Related Barriers

• Long waiting time for appointment and referrals
• Long waiting time in provider’s office
• Inconvenient office hours
• Complicated telephone system (not “user-friendly”)

Patient-Related Barriers

• Misinformation or confusion about certain issues such as
  • The meaning of TST results, for example, a positive TST result is thought to be normal or common in all foreign-born persons
  • Differences between injections, vaccines, and TST
  • The words “positive” and “negative” as they relate to test results
  • Modes of TB transmission and prevention
  • Exposure vs. becoming infected
  • Safety of family and friends around someone with LTBI
• Residential instability
• Lack of financial resources
• Poor access to health care
• Stigma associated with tuberculosis
• Co-existing medical conditions
• Culture and language
• Religious practices (e.g., fasting from food)

Treatment Barriers

• Complexity and duration of treatment
• Medication side effects
• Obtaining refills
• Frequency of office visits
• Cost, including insurance co-payment

Techniques to Improve Adherence

• Collaborate with local health department to provide treatment.
  • DOT, if patient is high risk (e.g., HIV infected, young child, or TB contact)
  • DOT should be provided with the 12-dose regimen or other intermittent regimens
  • Case management to coordinate care and services
  • Free or low-cost medication
  • Rewards for adherence (incentives) such as grocery store or restaurant vouchers, nutritional supplements, cell phone minutes, or movie tickets
  • Enablers to overcome barriers such as free van transportation or bus tickets
• Provide patient education and instructions in patient’s primary language at every visit.
• Ensure confidentiality.
• Suggest or provide patient reminders such as pill box, calendar, or timer.

• Page last viewed: tháng một 9, 2016
• Page last updated: November 25, 2013

Content Source:

Division of Tuberculosis Elimination