Psychotherapy Improves Compliance with Tuberculosis Treatment

Abstract

Background: Low treatment completion rate in tuberculosis (TB) patients is a major concern. Physicians have always been striving for better treatment adherence in such patients. The present study is one such attempt in this direction. Objectives: The study was aimed to evaluate the role of behavior modification by psychotherapy in improving compliance with short-course anti-TB chemotherapy in India. Methods: It was a prospective controlled trial involving patients with confirmed pulmonary and extrapulmonary TB enrolled in the National Tuberculosis Program. The intervention group underwent pretreatment psychological assessment followed by regular psychotherapy sessions. Results: The intervention group had a demographic profile comparable to that of the control group. The patients were mostly from low- and middle-income backgrounds from urban and semi-urban areas. They consistently showed poor knowledge about the nature of the disease, low motivation, and had considerable apprehensions. Following the sessions, the intervention group showed improved compliance compared with the control group, reflected in significantly higher treatment completion and cure rates. Conclusions: The study suggests that psychological intervention is effective in improving compliance with anti-TB treatment, and may reduce the incidence of treatment failure, relapse and drug resistance.

Psychosocial support groups for patients with multidrug-resistant tuberculosis: Five years of experience

“…Another study in India found that individual psychotherapy, utilizing principals of motivational interviewing among drug-sensitive TB patients with no mental illness, contributed to significantly higher rates of treatment adherence (Janmeja et al 2005). In our experience, psychosocial support groups have proved useful in helping patients manage some of the difficulties associated with treatment.…”

The Psychosocial Challenges Facing Multi Drug Resistance Tuberculosis Patients: A Qualitative Study

“…10,11,12,13 Moreover stigma also had its direct impact by affecting patients in multiple ways and it has been shown to hinder adherence to treatment. Utilizing principles of motivational interviewing which was found to be effective in improving treatment adherence in India, 14 could be further explored among MDR-TB patients. In addition to educating to patients, their families and employers on MDR-TB it becomes important to help them (patients) understand their problems and help them to overcome both perceived and enacted social stigma.…”

A Randomized Controlled Intervention Trial: Effect of Counselling on Treatment Adherence and Self-Esteem of Women Patients Receiving Tuberculosis Treatment

“…study conducted in Senegal on CAT-I TB patients showed that in comparison to control group (16.8%), default rate was decreased up to 5.5% in intervention group receiving counselling interventions [15]. Likewise, a study in India suggests that psychotherapy with motivational interviewing techniques among MDR TB patients without any psychological problem significantly enhanced treatment adherence [16].…”