Multi-Level Barriers to LTBI Treatment: A Research Note

Hill, Linda; Blumberg, Elaine J.; Sipan, Carol L.; Schmitz, Katharine E.; West, Joshua H.; Kelley, Norma; Hovell, Melbourne F.

doi:10.1007/s10903-008-9216-5

Cited by 18 publications

(45 citation statements)

References 16 publications

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“…Two studies suggested both financial and nonfinancial barriers were associated with low adherence rates, including the relative poverty of LTBI patients and work conflicts, which posed challenges for attending clinic appointments. Travel time to and from the clinic represented time absent from work, resulting in patients missing appointments and abandoning treatment . Lack of transportation to clinics was another important patient‐level barrier …”

Section: Resultsmentioning

confidence: 99%

“…This impacted access to education and training for health professionals to ensure they were able to remain up‐to‐date with current LTBI guidelines and treatment strategies. For example, some discussed the challenge of not being able to receive credit or approved study leave to attend LTBI in‐service training . In addition, LTBI patients often presented with complex issues and providers discussed the need for longer appointments to address complex cases and have sufficient time to conduct appropriate adherence and adverse effect counseling.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, inconsistent or even contradictory messages from different providers (nurses, health care workers, and private providers) were found to act as a barrier that resulted from a lack of coordination of LTBI care . In one study, providers planned to continue prescribing and dispensing 2 to 3 months or more of medication at a time, since they believed that “their patients would not return monthly”; however, patients were not always able to access this amount of medication . Furthermore, White et al found that information given by providers was not always appropriately targeted, particularly to patients with lower levels of education and who did not speak English as their first language.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Barriers to treatment adherence for individuals with latent tuberculosis infection: A systematic search and narrative synthesis of the literature

Liu

Birch

Newbold

et al. 2018

Health Planning & Management

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Barriers to treatment adherence for individuals with latent tuberculosis infection: A systematic search and narrative synthesis of the literature

Liu

Birch

Newbold

et al. 2018

Health Planning & Management

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“…Lengthy courses of therapy in asymptomatic patients are typically associated with high rates of poor adherence and loss to follow-up, with resultant decrease in efficacy of LTBI treatment programs 3. Strategies to improve adherence with therapy have included educational programs, support from pharmacists and other allied health care providers, medication alarms and reminder systems; however the establishment of effective short-course regimens are ultimately likely to provide the most benefit in this setting 4–6…”

Section: General Principles Of Ltbi Therapymentioning

confidence: 99%

The use of anti-tuberculosis therapy for latent TB infection

Denholm

McBryde²

2010

IDR

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Tuberculosis infection is of global public health significance, with millions of incident cases each year. Many cases, particularly in low-prevalence settings, result from the reactivation of latent tuberculosis infection (LTBI); potentially acquired years prior to active disease. Up to one-third of the world’s population has been infected with LTBI, and so may be at risk for future active TB disease. A variety of antituberculosis medications and treatment regimens have now been evaluated in the management of LTBI, with the aim of eradicating tuberculosis bacilli and reducing the likelihood of subsequent reactivation disease. This article reviews LTBI therapies and their use in clinical contexts, and considers future directions for individual and population-based strategies in LTBI management.

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“…This factor may explain why HCWs are unaware of TB epidemiology and pathogenesis and did not recognise the consequences of latent TB. A study assessing LTBI treatment of immigrants [14] also found that providers lacked knowledge of TB, both in written tests and in practice.…”

mentioning

confidence: 99%

Factors influencing tuberculosis screening in healthcare workers in Portugal

2014

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Although the incidence of tuberculosis (TB) has increased in healthcare workers (HCWs) [1][2][3], several studies have shown that HCWs are not compliant with screening and/or preventive measures [4][5][6][7]. For example, a Portuguese study found that the estimated TB incidence was three-to seven-fold higher in HCWs than in the general population [8]. Latent TB infection (LTBI) diagnosis and treatment constitute the core of TB elimination, integrating the post-2015 strategies of the World Health Organization [9,10].To evaluate TB screening practices among HCWs and their reasons for nonadherence in Portugal, we developed a survey and distributed it to nurses and physicians from December 25, 2012 to January 31, 2013, closing when we received fewer than one response per day. The survey was anonymous, voluntary and digitally distributed through our network of contacts using a "snowball" distribution method where volunteers subsequently distribute the questionnaire to their contacts and so forth.Continuous data are presented as mean±SD and compared using t-tests. Categorical data are presented as n (%) and compared using the Chi-squared or Fisher's test, as appropriate. Multiple logistic regression analysis was used to identify statistically significant determinants of TB infection, exposure and screening. Crude and adjusted odds ratios and 95% confidence intervals were determined. Goodness-of-fit of the models was evaluated; comparisons with the null model used the difference of deviances, as determined by Chi-squared tests, while comparisons with the saturated model used the difference of deviances, determined using the Chi-squared or Hosmer-Lemeshow test, as appropriate. The area under the receiver operating characteristic (ROC) curve was calculated for each model. All statistical analyses were performed using the R language and software, version 2.12.1 [11]. The level of significance was fixed at 0.05.In Portugal, in 2008, there were 38 932 physicians and 56 859 nurses registered by their respective boards [12].We obtained 2414 responses, of which 399 did not meet the inclusion criteria. Thus, responses from 2015 subjects were analysed; table 1 summarises the results. Of these subjects, 1540 (76.4%) were females and 1133 (56.2%) nurses. Subjects were aged 18-73 years (mean±SD 39.02±10.60 years). 44 (2.2%) subjects had a history of TB (20 before beginning professional activity).

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Multi-Level Barriers to LTBI Treatment: A Research Note

Cited by 18 publications

References 16 publications

Barriers to treatment adherence for individuals with latent tuberculosis infection: A systematic search and narrative synthesis of the literature

Barriers to treatment adherence for individuals with latent tuberculosis infection: A systematic search and narrative synthesis of the literature

The use of anti-tuberculosis therapy for latent TB infection

Factors influencing tuberculosis screening in healthcare workers in Portugal

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