<p>Risk Stratification and Factors Associated with Abandonment of Tuberculosis Treatment in a Secondary Referral Unit</p>

Abstract

To study the factors associated with the risk of discontinuing active tuberculosis treatment among patients in an outpatient referral unit and to analyze the association between patients' abandonment risk score and their odds of discontinuing the treatment. Patients and Methods: In this cohort study, tuberculosis patients were prospectively followed up from June 2012 through July 2019 at a secondary tuberculosis referral unit in Mato Grosso do Sul, Brazil. At initial consultation, patients were interviewed using a standardized questionnaire and were assigned a score for the risk of treatment abandonment by the nurse. Univariate and multivariate analyses were performed using logistic regression. Results: One hundred and forty-eight patients were included in the study, of which 65.0% (96/148) were male. Their mean age was 43.3 ± 14.8 years (range: 18-89 years). Smoking, drug use, repeated admissions, and a high abandonment risk score were the variables associated with the highest risk of discontinuing the treatment. The rate of tuberculosis and human immunodeficiency virus coinfection was 37.2%. The overall rate of global treatment abandonment was 10.8% (95% confidence interval [CI]: 6.1-16.2). Upon stratification of patients that abandoned by the risk score, 22.9% (8/35) of the ones that abandoned had a high risk, 10.9% (6/55) had an intermediate risk, and 3.5% (2/58) had a low risk of treatment abandonment. In multivariate analysis, the factors associated with abandoning the treatment were smoking [adjusted odds ratio (aOR) = 4.91 (95% CI: 1.08, 22.32)] and undergoing retreatment (aOR) = 3.66 (95% CI: 1.04, 12 88). Conclusion: Smoking and undergoing retreatment were independent risk factors for tuberculosis treatment abandonment in this center. Risk stratification can help prioritize the strengthening of treatment adherence among patients at higher risk of abandoning treatment in referral units.

Estudo Psicométrico Da Escala De Satisfação Com O Suporte Social Em Pessoas Com Tuberculose Pulmonar

“…O Suporte Social, também chamado de apoio social, tem sido uma variável que a literatura espelha como um determinante do bem-estar físico, social e psicológico 2,9,12,14,20 . Abrange políticas e redes de apoio como família, amigos e comunidade, que têm como finalidade contribuir para o bem-estar das pessoas, incluindo àquelas em situação de exclusão 9,12,14,[21][22][23] .No contexto de doença, a importância do Suporte Social no bem-estar psicológico das pessoas acometidas e a sua influência no seu tratamento tem sido bem documentada (2, 6-8, 13, 20-25) .…”

“…O apoio familiar e o apoio social são fatores centrais no sucesso do tratamento para tuberculose, na medida em que a evidência científica o descreve como fator-chave para a adesão ao tratamento [21][22][23][24][25] . Por conseguinte, é de relevante importância o desenvolvimento de instrumentos de medida de satisfação do Suporte Social devidamente adaptados à população, onde se identifique ser oportuno avaliar esta variável.…”

Estudio Psicométrico De La Escala De Satisfacción Con El Apoyo Social en Personas Con Tuberculosis Pulmonar

“…El apoyo social, también llamado apoyo social, ha sido una variable que la literatura refleja como determinante del bienestar físico, social y psicológico 2,9,12,14,20 . Abarca las políticas y las redes de apoyo, como la familia, los amigos y la comunidad, cuyo objetivo es contribuir al bienestar de las personas, incluidas las que se encuentran en situación de exclusión 9,12,14,[21][22][23] .En el contexto de la enfermedad, la importancia del apoyo social en el bienestar psicológico de las personas afectadas y su influencia en su tratamiento está bien documentada 2, 6-8, 13, 20-25 .…”

“…El apoyo familiar y el apoyo social son factores centrales para el éxito del tratamiento de la tuberculosis, ya que la evidencia científica lo describe como un factor clave para la adherencia al tratamiento[21][22][23][24][25] . Por lo tanto, es de relevancia el desarrollo de instrumentos de medición de la satisfacción del Apoyo Social debidamente adaptados a la población, donde se identifica como apropiado evaluar esta variable.En este estudio, adaptamos la ESSS10 de Pais-Ribeiro para una muestra de personas con tuberculosis pulmonar.…”

Psychometric Study of the Social Support Satisfaction Scale in People With Pulmonary Tuberculosis

“…Social Support, also called social support, has been a variable that the literature mirrors as a determinant of physical, social, and psychological well-being 2,9,12,14,20 . It encompasses policies and support networks such as family, friends, and community, which are intended to contribute to the well-being of people, including those in situations of exclusion 9,12,14,[21][22][23] .In the context of illness, the importance of Social Support in the psychological wellbeing of people affected and its influence on their treatment has been well documented (2, 6-8, 13, 20-25).…”