Non adherence in isoniazid treated patients as measured by “Temptation to skip therapy” scale
Background: Every year TB accounts for 2 million deaths worldwide. Management of tuberculosis by patient centered approaches has been a major component of the WHO.s Global Plan to Stop TB (2006-2016). Adherence plays a vital role in success of treatment and poses a challenge due to the asymptomatic nature of TB. This study examines major factors influencing the adherence to the TB therapy. Objective: The specific aim of the study is to examine the Temptation to skip therapy (TEST) scales as a major predictors of adherence. We examined medication adherence in relation to medical doubts, lack of social support, and medication side effects in TB patients. We also elucidated the most influential predictor among the three subscales variables by using logistic regression models. Methods: Questionnaires were completed by 212 TB patients on isoniazid therapy aged 18-66 at Rhode Island Tuberculosis Clinic at baseline at 6 months follow-up to measure adherence. The average score was computed for each TEST subscale and the association of each subscale and adherence calculated by using Morisky Medication Adherence Scale (MAS) was examined. Analysis was performed using backward selection in the logistic regression model. Results: Adherence to the isoniazid (INH) therapy was 46% (by MAS). It was found that the TEST scales (P Value 0.0208 OR 0.612 CI 0.403-0.928) were major predictors of the isoniazid therapy. Except “years of education” none of the demographic variables was found to be significantly associated to isoniazid adherence.Isoniazid treated patients having higher scores on Medical Doubt (P Value 0.0166, OR=0.590, CI=0.384-0.908) subscale were less likely to be adherent to the medication therapy than other demographic and clinical variables. Conclusion: Latent TB patients exhibited low adherence with isoniazid therapy. Apart from “Years of education”, demographic variables have a negligible impact on adherence. Among the 3 subscales, Medical doubt was seen as the strongest independent predictor. TEST subscales can be potentially considered as a strong predictor of adherence. This suggests the need for in-depth analysis and further studies to better understand TEST scale in order to devise more streamlined interventions for TB therapy. Keywords: Temptation, Isoniazid, Intentional Non-adherence.
"Non adherence in isoniazid treated patients as measured by “Temptation to skip therapy” scale"
Dissertations and Master's Theses (Campus Access).