Patients’ perception towards directly observed treatment – A qualitative study from Kollam district, Kerala, southern India

User-experience and patient satisfaction with quality of tuberculosis care in India: A mixed-methods literature review

“…In 5 studies that specifically quantified patient perceptions of providers’ behaviour or attitude, a majority of patients reported being satisfied or viewed it favourably [57], [58], [59], [60], [61]; 4 of these studies were conducted amongst patients attending DOTS in UP, while 1 study was in Madhya Pradesh (MP). Positive experiences are supported by qualitative evidence from Karnataka, Delhi and Mumbai where patients narrated instances where providers went out of their way to support patients psychologically [85], financially [62], or by adapting to patients’ unique needs and preferences for DOTS [79,84,85]. Patients greatly appreciated this flexibility and trust, particularly from PP's [84] and in rural regions [85] in South India, including DOTS providers coming early in the morning [84,85] or allowing patients to take their medicines at home where they are more comfortable when experiencing immediate side-effects [79].…”

“…Respect: The behaviour and attitude of health workers were cited in 16 studies by patients as having impacted their user-experience [57], [58], [59], [60], [61], [62],68,73,75,[77], [78], [79],[83], [84], [85], [86]. In 5 studies that specifically quantified patient perceptions of providers’ behaviour or attitude, a majority of patients reported being satisfied or viewed it favourably [57], [58], [59], [60], [61]; 4 of these studies were conducted amongst patients attending DOTS in UP, while 1 study was in Madhya Pradesh (MP).…”

“…Ease of use: Twenty-four studies from across regions included patients impacted by the ease of use of TB care delivery, including the frequency of visits and schedules of DOTS centres [57], [58], [59], [60], [61], [62], [63], [64], [65],68,70,73,74,[76], [77], [78], [79],[83], [84], [85], [86], [87], [88], [89]. Out of these, 22 studies included patients finding the timing and schedule of care delivery inconvenient and difficult to use.…”

“…Out of these, 22 studies included patients finding the timing and schedule of care delivery inconvenient and difficult to use. Patients consistently found the frequency of DOTS visits to be a challenge and barrier during treatment [57,[60], [61], [62],64,68,70,76,84,85]. The unsuitable timings of clinics conflicted with work and daily activities, which were reported in 15 studies as reasons for DOTS non-compliance or interruption [63,65,73,74,79,83], delays during treatment and diagnosis [64,77,86,87], and as a general problem or dissatisfaction in availing treatment [57,58,60,78,88]. “…If he [another TB patient] does not go for his treatment, he will die and if he does not go for work, his children will die” [65 year old male TB patient, Karnataka] [84] .…”

“…Qualitative data reveal that patients had to make adjustments to their daily routines, and in some cases endure pain and breathlessness to reach the facility every alternate day [62,84,85]. Contrastingly, 2 studies in rural settings in UP and MP, reported a majority of patients finding timings of DOTS centres convenient or not affecting work [59,61].…”