Acceptance of treatment for latent tuberculosis infection: prospective cohort study in the United States and Canada

Colson, Paul W.; Hirsch‐Moverman, Yael; Bethel, Jim; Vempaty, Padmaja; Salcedo, Katya; Wall, Kirsten; Miranda, Wilson; Collins, Susan E.; Horsburgh, C. Robert

doi:10.5588/ijtld.12.0697

Cited by 38 publications

(49 citation statements)

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“…Each of the 12 TBESC sites was associated with one to five public health clinics that enrolled study participants; enrollment into the larger study is discussed in Colson et al 10 This analysis follows the 1515 enrollees who accepted LTBI treatment (see Colson et al for an analysis of LTBI treatment acceptance 10 ); of this group, the clinic charts of 192 participants could not be located, resulting in 1323 participants with evaluable outcomes and therefore eligible for the completion analysis. The 192 participants lacking chart information were concentrated in two clinics.…”

Section: Resultsmentioning

confidence: 99%

“…See Colson et al 10 and Pettit et al 11 for further details on in-person interviews and chart abstraction. At each site, the study coordinator and clinic director determined who would complete the clinic survey, in which information was collected on clinic population, procedures, and services.…”

Section: Methodsmentioning

confidence: 99%

“…This is the third report on the results of this study. Earlier work reported on acceptance of LTBI treatment 10 and treatment discontinuation due to adverse events. 11 In this analysis, we assess LTBI treatment completion rates and identify risk factors associated with completion/non-completion of LTBI treatment.…”

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confidence: 99%

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Latent tuberculous infection in the United States and Canada: who completes treatment and why?

Hirsch‐Moverman

Shrestha-Kuwahara

Bethel³

et al. 2015

int j tuberc lung dis

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SUMMARY OBJECTIVES To assess latent tuberculous infection (LTBI) treatment completion rates in a large prospective US/Canada multisite cohort and identify associated risk factors. METHODS This prospective cohort study assessed factors associated with LTBI treatment completion through interviews with persons who initiated treatment at 12 sites. Interviews were conducted at treatment initiation and completion/cessation. Participants received usual care according to each clinic’s procedure. Multivariable models were constructed based on stepwise assessment of potential predictors and interactions. RESULTS Of 1515 participants initiating LTBI treatment, 1323 had information available on treatment completion; 617 (46.6%) completed treatment. Baseline predictors of completion included male sex, foreign birth, not thinking it would be a problem to take anti-tuberculosis medication, and having health insurance. Participants in stable housing who received monthly appointment reminders were more likely to complete treatment than those without stable housing or without monthly reminders. End-of-treatment predictors of non-completion included severe symptoms and the inconvenience of clinic/pharmacy schedules, barriers to care and changes of residence. Common reasons for treatment non-completion were patient concerns about tolerability/toxicity, appointment conflicts, low prioritization of TB, and forgetfulness. CONCLUSIONS Less than half of treatment initiators completed treatment in our multisite study. Addressing tangible issues such as not having health insurance, toxicity concerns, and clinic accessibility could help to improve treatment completion rates.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Latent tuberculous infection in the United States and Canada: who completes treatment and why?

Hirsch‐Moverman

Shrestha-Kuwahara

Bethel³

et al. 2015

int j tuberc lung dis

Self Cite

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“…[73][74][75][76] By focusing on screening high-risk population groups for TB reactivation, individuals may be identified and educated about LTBIs and recommended treatment. 77 Together with cost-effective diagnostic measures, educa- Tuberculin skin tests are preferred over interferon-␥ release assays as the diagnostic tool in children Ͻ5 years old.…”

Section: Discussionmentioning

confidence: 99%

Advances in Diagnosis and Treatment of Latent Tuberculosis Infection

Chapman

Lauzardo

2014

The Journal of the American Board of Family Medicine

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“…The study found that among healthcare workers, 52% rejected treatment [4]. Another American study also showed poor uptake of treatment for LTBI among healthcare workers, possibly suggesting that they might have some doubts about whether treatment of LTBI is beneficial to them personally [5].…”

Section: Introductionmentioning

confidence: 98%

Benefit of treatment of latent tuberculosis infection in individual patients

2015

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We aimed to develop a decision aid that estimates whether treatment of latent tuberculosis infection (LTBI) is likely to have a net gain in quality-adjusted life-years for an individual.A Markov model was developed which incorporated personalised estimates for risk of tuberculosis (TB) reactivation, TB death, quality-of-life impairments and treatment side-effects. The net effect of LTBI treatment was quantified in terms of quality-adjusted life-years gained or lost. Analyses were conducted for a representative set of hypothetical patients.LTBI treatment was estimated to be beneficial when the annual risk of TB reactivation exceeded 13/100 000 to 93/100 000 for females aged 10-75 years and 15/100 000 to 119/100 000 for males aged 10-75 years; the numbers needed to treat to avoid one case of TB were 93, 77, 85 and 72, respectively, at these threshold levels.LTBI treatment was estimated to confer a positive net benefit across a broad range of patients with characteristics typically seen in a low incidence setting for TB. Use of the decision aid has the potential to facilitate and increase confidence with LTBI treatment decisions by providing clinicians and patients with personalised estimates of likely net benefit. @ERSpublications Personalised analysis showed that most people with latent tuberculosis infection benefit from preventive treatment

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Acceptance of treatment for latent tuberculosis infection: prospective cohort study in the United States and Canada

Cited by 38 publications

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Latent tuberculous infection in the United States and Canada: who completes treatment and why?

Latent tuberculous infection in the United States and Canada: who completes treatment and why?

Advances in Diagnosis and Treatment of Latent Tuberculosis Infection

Benefit of treatment of latent tuberculosis infection in individual patients

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