Evaluating Adherence to Medication among Tuberculosis Patients

A BSTRACT Background: Adherence to the treatment determines the success of anti-tuberculosis (TB) treatment. Non-adherence leads to relapse of disease, the interminable transmission of disease, and the rise in the development of drug-resistance strains of Mycobacterium tuberculosis . Objective: To study adherence to the anti-TB treatment and to identify factors determining treatment adherence. Methodology: A cross-sectional observational study was conducted among 1574 TB patients undergoing Directly Observed Treatment, Short-Course (DOTS) therapy at primary health centers in various districts of Haryana. A questionnaire-based interview was conducted to gather information about treatment adherence and to identify the factors responsible for non-adherence. Results: Among TB patients, the default rate was 7.7%. The treatment completion rate was 55.7%, and the cure rate was 17.7%. The prevalence of nonadherence to anti-TB treatment was 10.1%. Age, gender, educational qualifications, and occupation exhibited no significant association, whereas marital status was significantly associated with adherence to anti-TB treatment. Family support, attendance at the workplace, change of job, change of people’s behavior, stress and nervousness, confidence to handle day-to-day personal life, ability to cope with problems in life, ability to control irritation, anger for things being out of control, and feeling worse on treatment were the factors having significant association with adherence to anti-TB treatment. Knowledge and awareness about DOTS treatment, side effects, and curability of TB significantly affected adherence to anti-TB treatment. Conclusion: Various factors, including forgetfulness, behavior change in society, job-related factors, and knowledge about treatment, play a major role in determining treatment adherence.