Quality of care provided to tuberculosis patients in Armenia: How satisfied are the patients?

Abstract

Introduction: Adherence to tuberculosis (TB) treatment as an important determinant for the successful cure of patients can be increased by focusing on patient satisfaction. The objective of this study was to evaluate patient satisfaction with TB services, different aspects of patient satisfaction, and demographic, health and treatment characteristics associated with satisfaction.
 Methodology: Overall 505 randomly selected TB patients that received treatment during 2014-2015 in Armenia underwent a cross-sectional telephone survey. Patient satisfaction items were selected from the Patient Satisfaction Questionnaire (PSQ-18). The Consultation and Relational Empathy (CARE) and Patient Enablement Instrument (PEI) were also used. Treatment adherence was assessed using the Morisky Adherence Scale.
 Results: The respondents comprised 386 (76.4%) men and 119 (23.6%) women with a mean age of 45.5 ± 0.7 years. Nearly 99% (n = 500) of them were treatment-adherent. However, 45 (8.9%) mentioned the side effects as a reason for not following the treatment, revealing the non-adherence level of approximately 9%. About 93% of the patients were generally satisfied with the TB services, about 46% were satisfied with consultation and relational empathy and about 95% were satisfied with patient enablement. Being unsatisfied with TB services was associated with treatment non-adherence, inpatient treatment, drug-resistant TB, higher education, being unmarried, having a family income of below 50,000AMD (~120 USD) on average, being unsatisfied with consultation and empathy and place of residence.
 Conclusions: This study reports that TB patients are highly satisfied with TB care in Armenia. However, addressing specific characteristics associated with satisfaction may improve the TB program.

Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: a mixed methods systematic review and meta-analysis

“…Evidence from 13 studies contributed to the quantitative narrative synthesis and meta-analyses ( Table 1 ): four RCTs 21 , 22 , 23 , 24 ; one quasi-randomised trial 25 ; eight non-randomised studies, including five cohort study designs, 26 , 27 , 28 , 29 , 30 two before-and-after study designs 31 , 32 and one mixed methods study. 33 Evidence from 10 qualitative studies 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 and one mixed methods study 33 contributed to the thematic synthesis ( Table 2 ). Three quantitative studies 24 , 30 , 31 have ‘sibling’ qualitative studies 35 , 36 , 39 pertaining to the same intervention; these are counted as one ‘study’ in the narrative description of study characteristics, but both are cited in the text.…”

“…Studies were conducted in 13 countries across five of the six WHO world regions: four studies in the African region (Ethiopia, Eswatini, Nigeria and South Africa) 23 , 31 , 36 , 37 , 41 ; five studies in the Region of the Americas (Argentina, Brazil and Peru) 22 , 24 , 26 , 27 , 35 , 40 ; five studies in the South-East Asia Region (India and Nepal) 25 , 28 , 29 , 38 , 42 ; four studies in the European Region (Armenia, Ukraine and Uzbekistan) 21 , 30 , 34 , 39 , 43 ; and one study in the Western Pacific Region (China). 33 Nine studies were conducted in countries with a high incidence of TB, TB and HIV and multi-drug resistant TB (MDR-TB) 23 , 25 , 28 , 29 , 31 , 32 , 36 , 37 , 42 ; three studies in countries with a high incidence of TB and TB and HIV 22 , 26 , 40 ; three studies in countries with a high incidence of MDR-TB 24 , 30 , 35 , 39 , 43 and five studies in countries not considered high incidence, 21 , 27 , 34 , 38 , 41 according to the WHO classification at the time of the study. Ten studies included participants with any type of active TB or did not specify 22 , 23 , 24 , 26 , 30 , ...…”

“… 33 Nine studies were conducted in countries with a high incidence of TB, TB and HIV and multi-drug resistant TB (MDR-TB) 23 , 25 , 28 , 29 , 31 , 32 , 36 , 37 , 42 ; three studies in countries with a high incidence of TB and TB and HIV 22 , 26 , 40 ; three studies in countries with a high incidence of MDR-TB 24 , 30 , 35 , 39 , 43 and five studies in countries not considered high incidence, 21 , 27 , 34 , 38 , 41 according to the WHO classification at the time of the study. Ten studies included participants with any type of active TB or did not specify 22 , 23 , 24 , 26 , 30 , 32 , 34 , 35 , 39 , 40 , 42 , 45 ; seven studies included only people with drug-resistant TB (DR-TB) or MDR-TB 25 , 29 , 33 , 37 , 38 , 41 , 43 ; and four studies included only people with drug-sensitive TB (DS-TB). 21 , 27 , 28 , 31 , 36 …”

Midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography

“…The scores of these subscales were added together to form an overall satisfaction score. [10][11][12] The data of this study were analyzed with SPSS 22.0. Continuous data are summarised as the mean ± standard deviation, whereas categorical data are summarised as percentages.…”

Gaps in tuberculosis control in Armenia: How to improve the care system?

“…In recent years, several reforms in TB care took place in Armenia [6][7][8][9][10][11][12]. As a result, efficiency of the services was increased and unnecessary use of services was reduced [6,10].…”