A qualitative study of the reasons why PTB patients at clinics in the Wellington area stop their treatment

Abstract

BackgroundTuberculosis (TB) remains the leading infectious cause of adult mortality, despite 60 years of effective chemotherapy. One reason for this is the problem caused by the interruption and failure of treatment, which usually are related to non-adherence. The reasons for non-adherence to TB treatment are multifaceted, ranging from the personalities of the patients to the social and economic environment. In South Africa, the most common problems have been shown to be the erratic way in which the treatment is taken, and not patients absconding from the treatment program. There is a strong suspicion that the disability grants issued to TB patients are acting as a disincentive to finish anti-tuberculosis medication. TB is a stigmatised disease and the lack of support from health workers, family and friends, as well as the length of the treatment period, all contribute to the temptation to discontinue TB therapy. This research was undertaken in Van Wyksvlei, a sub-economic area of Wellington. Wellington is part of the Drakenstein Municipality in the Western Cape, South Africa and is mainly an agricultural area. The aim of the study was to explore and describe the reasons why patients in the Wellington area do not complete their TB treatment, and then to make recommendations to improve adherence.

It’s complicated: why do tuberculosis patients not initiate or stay adherent to treatment? A qualitative study from South Africa

“…Although not identified in this study as a serious problem, the related area of stigma and fear around TB needs to be monitored, as was shown previously in the Western Cape [17] since it is getting more important as TB increasingly becomes linked to HIV in the minds of community members [18, 19]. A number of patients spoke with great distress about being rejected by their family and community as a result of being diagnosed with TB.…”

Bench, bed and beyond: Communication and responsibility in decentralised tuberculosis care

“…Prior research has demonstrated that in order to obtain positive patient outcomes, effective communication and coordination is not only necessary at the level of communication between healthcare workers and patients, but also across multidisciplinary teams and contexts (Poole & Real 2003;Portwig & Couper 2006). Our results show that current mechanisms of communication in TB care are often not sensitive to what matters to patients and healthcare workers.…”

Faktor Penghalang dan Penggalak Kepatuhan daripada Perspektif Pesakit Tuberkulosis Cicir Rawatan di Kuala Lumpur

“…Tambahan lagi, ahli keluarga juga bertindak sebagai sumber penggalak dan penenang kepada pesakit yang sudah hilang harapan (Gebremariam et al 2010). Kesan kurang sokongan keluarga ke atas tingkah laku yang tidak patuh terhadap rawatan anti tuberkulosis juga dilaporkan dalam beberapa kajian terdahulu (Castelnuovo 2010;Portwig & Couper 2006;Sagbakken et al 2008).…”

“…Hal ini akan lebih mendesak pesakit tuberkulosis untuk tidak mampu meneruskan rawatan anti tuberkulosis seperti yang dinasihatkan dan desakan menyeimbangkan antara pekerjaan, pendapatan, dan komitmen kepada rawatan akan terus berlaku seandainya setiap satu daripada faktor ini tidak ditangani. Pengaruh pekerjaan ke atas kepatuhan rawatan dalam kalangan pesakit tuberkulosis turut sama dilihat dalam beberapa kajian kuantitatif dan kualitatif terdahulu (Cherkaoui et al 2014;Portwig & Couper 2006;SanchezPadilla et al 2014). Satu kajian tempatan yang dijalankan di Perak menunjukkan bahawa surirumah mempunyai tahap kepatuhan kepada rawatan yang lebih baik berbanding dengan mereka yang bekerja (Chuah 1991).…”