A Study to Assess the Therapeutic Compliance and Associated Factors among Tuberculosis Patients in Selected DOTS Centres of City Ludhiana, Punjab (original) (raw)
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TB DOTS PROGRAM: STATUS, COMPLIANCE AND REMEDIES
This study attempted to find out the status, compliance and remedies of TB DOTS program in Dapitan City. It sought to find out relationship of factors such as patient –health care professional communication, knowledge, beliefs about TB and resources to patient’s compliance on medication. Results revealed that majority of the tuberculosis patients were male, middle aged, married, economically unstable and had low educational attainment. They manifest shyness and reluctance in asking their health providers about information relative to their treatment/medication. The stigma of having inflicted tuberculosis, find visiting DOTS clinic as embarrassing and are not spared from believing misconceptions about tuberculosis. Patients are not totally compliant with doctors’ advice. They still resort to alcohol intake and cigarette smoking. They lack financial and social support even with the religious group support for counseling. Compliance to medication varies in age and to the degree of socio economic status. Communication to health-care professionals vary in terms of their age and socio-economic status. Younger and more economically stable have more open communication with their health providers. Health professionals are suggested to encourage TB patients to have open communication to develop sense of empathy, friendliness and respect in communicating to patients. Recommended remedies include public health education to raise public awareness. TB patients are encouraged to adhere to the doctors’ advice, stay away from taking alcohol, cigarettes and drugs. The government or NGO may organize a social support group. Family members and friends are also encouraged to serve as counselors. Key words and phrases: TB DOTS, Status, compliance and remedies
Introduction: Communicable diseases are the major public health problems in India. These are the deadly diseases, which affect the common population today. Tuberculosis is also one of the major communicable disease and chronic condition, it requires continuous medical care. The environment and socioeconomic risk associated with this condition are severe in developing countries like India. Objectives: 1) To assess the knowledge on DOTS among tuberculosis patients. 2) To assess the utilization of DOTS among tuberculosis patients. 3) To assess the compliance of DOTS therapy among tuberculosis patients. 4) To find out the association between the levels of knowledge on DOTS with selected demographic variables. Methodology: Non-experimental descriptive survey research design was adopted for the present study. Sample included 60 tuberculosis patients recruited by non-probability purposive sampling method. Structured interview schedule was used for collection of data. Results: The findings showed that 23.3% of the patients had inadequate knowledge as compared to 48.4% respondents with moderate knowledge level and 28.3% respondents with adequate knowledge regarding DOTS therapy, its utilization and compliance. Conclusion: Nearly 50% of samples were having Moderate knowledge regarding DOTS Therapy, its utilization and Compliance.
THE PROFESSIONAL MEDICAL JOURNAL
ORIGINAL PROF-4062 ABSTRACT… Background: TB is highly prevalent in Pakistan. The Pakistan government has, therefore, given high priority to Tuberculosis control. It has declared TB to be considered as National Emergency in 2001, and has extended the WHO suggested TB control strategy (or DOTS) throughout the all health services of the Health Ministry by May of 2005 1 .Therefore it is very essential to assess the knowledge about TB and its implementation in tertiary hospitals which are the main source of providing treatment. Objectives: To assess the knowledge of medical offices about the diagnosis of tuberculosis case, treatment of tuberculosis cases and the practice of TB DOTS by the MOs in teaching hospitals of Faisalabad City. Place and Duration of Study: It was carried out in teaching hospitals. "Allied Hospital and district head quarter hospital" in Faisalabad City, in one month from 10 June 2014 to July 10 2014, Fifty MOs were assessed by the questionnaires methodology. Study Design: The study design was cross sectional study. Sample Technique: Simple non-random sampling. Materials & Methods: The MOs were given the questionnaires and before filling it, they were also provided with consent form, to get their consent in written. The sample of consent form and questionnaires are given at end. MOs are assessed randomly. Results: In this study, the response obtained in questionnaires were analyzed individually. When we calculate the percentage of doctors have knowledge about DOTS in Faisalabad. We get following results: 77.5% of MOS in teaching hospital of Faisalabad have knowledge about DOTS in Faisalabad. When we calculate the percentage of doctors practicing DOTS in Faisalabad. We get following results so 18.64% of MOs practice DOTS. Conclusion: It was concluded from this study that though majority of MOs have the knowledge but they are not practicing it. So there is a need of strict enforcement to implement this program effectively to achieve a better control of TB under guidelines of WHO.
An Innovative Method to Enhance the Modified DOTS for TB Patients
Tanaffos, 2015
Nowadays establishing communication and educating patients to enhance their knowledge regarding disease and treatment process at home is one of the most important principles in providing patient care. A semi-experimental study was done on 57 patients with active pulmonary tuberculosis in two care groups namely professional - family mix directly observed treatment short- course (PFM-DOTS) and family based-DOTS (FB-DOTS). The patients were referred to the tuberculosis and lung diseases research center for diagnosis and treatment of pulmonary tuberculosis. Both the patient and a family supervisor were evaluated regarding their level of knowledge of the disease and the treatment regimen. A significant difference between the degree of knowledge of groups of patients and the groups of family relatives before and after the intervention was indicated, with a higher increase in PFM-DOTS group than in F-B-DOTS group (P< 0.001). In PFM- DOTS group 100% of the patients, and in the FB-DOTS gr...
IOSR Journal of Nursing and Health Science, 2016
Tuberculosis is one of the leading causes of morbidity and mortality around the world. Globally, the DOTS has been recognized as the best cost-effective approach for tuberculosis control and reduction of disease burden. The persons suffering from tuberculosis have difficulty in following a long-term treatment regimen. A non-experimental research approach was adopted for the study and exploratory research design was employed to explore the factors associated with adherence to DOTS therapy among tuberculosis patients. The Convenient Sampling technique was used to select the sample. The results of study showed that majority of the respondents 70% were adhered while 30% were non adhered to DOTS treatment. The findings revealed that area of residence and satisfaction with information received from health care personnel, were associated with adherence to DOTS therapy. Moreover, accessibility of health care facility, convenient TB center opening time, confidentiality issues, health personnel behavior, psychological stress due to continuation of DOTS therapy, relief from symptoms, difficulty in taking DOTS therapy and family support had also significant relationship with adherence to DOTS therapy while waiting time, paying money, language problems, supervision, side effects and social stigma were found to be non significant factors. The patients describes difficulties they were facing as long duration of treatment, quantity of pills, side effects and interference of DOTS therapy in daily routine. Thus, it implies that still, there is need of necessary interventions to reduce and eliminate the factors leading to non adherence as well as promotion of factors leading to adherence to DOTS therapy.
Role of Counselling to Facilitate Compliance to the Dots for the Treatment of Tuberculosis
Objectives: The objective of the research was to determine and compare the effectiveness of structured counseling to improve adherence and continuation of directly observed treatment (DOTS). As multi drug resistance (MDR) is common due to default among TB patients, to overcome that counseling can play an important role. The sample comprised of sixty patients (N=60) diagnosed with pulmonary tuberculosis. The random sampling technique was used for the assignment of the patients to the experimental group (n= 30) and a control group (n=30). Data was analyzed with SPSS version 12. Results: The results indicated that the majority of the experimental group patients adhered to the therapy 25 (83.3%) till the last follow –up counseling session dropout rate was 5 (16.6%) while among control group 9 (30 %) continued the treatment and kept on coming up for follow up sessions their dropout rate was 21 (70%). Conclusion: Counseling of patients is important to optimize therapy, aid compliance and to inform patients' of any potential complications of therapy.
Pakistan Journal of Chest medicine, 2015
Background and Objectives: Almost one third of the world‟s population is infected with the tuberculous bacilli. Effective treatment of tuberculosis requires adherence to treatment with multiple drugs for minimum of 6 months. WHO DOTS-strategy was launched in 1993 to improve treatment adherence and cure rates.This study is aimed to compare TB treatment and outcomes before and after the introduction of daily directly observed therapy (DOTS). Methods: The study employed a retrospective record review comparative study design and was conducted at the TB clinic of Pulmonology department of Lady Reading Hospital Peshawar. We compared treatment outcomes among all TB patients treated for pulmonary and extra pulmonary tuberculosis in the TB clinic from 2001 through 2006 with 2001 to 2003 and 2004 to 2006, before and after DOTS implementation respectively. Results: The study included 1235 cases with 867 patients before and 368 after introduction of DOTS. There were 631 (51.1%) males and 604 (4...
Study of treatment outcomes in tuberculosis patients on DOTS therapy at five centres in Goa
International Journal of Community Medicine and Public Health, 2014
The objective was to study the treatment outcomes in tuberculosis patients on DOTS therapy in five centres in Goa in terms of cure rates, treatment completion rates, unfavourable outcomes and factors responsible for unfavorable outcomes. Methods: Study setting: It was a facility based study at five DOTS centres from the Panaji Tuberculosis Unit (TU). Study design: prospective follow up design was used for the study. Study subjects: All patients registered at the selected five DOTS centres for DOTS therapy under RNTCP in the period from 1 st April 2011 to 31 st December 2011 were selected as study subjects and followed prospectively for a period of nine months till 30 th September 2012. Study instruments: data was collected from patients by personal interview and a pretested structured questionnaire. Data was also obtained from patient treatment cards and by interviewing the DOTS provider. Statistical analysis: Data was analysed using SPSS software. The statistical tests used were frequencies, descriptive, Chi square test, odds ratio and logistic regression analysis. Results: Overall 42.9% of the patients were declared cured, 42.3% had treatment completed as the outcome, 4.9% were defaulters, 2.7% patients died, 1.6% were classified as treatment failure, 2.2% were transferred out and 0.5% of the patients were shifted to Non-DOTS treatment regimen while in 2.7% of the patients treatment outcome was not available. Presence of diabetes mellitus, hypertension and alcohol use were found to be significantly associated with unfavourable outcomes in Tuberculosis patients on DOTS. Conclusions: Patients with alcohol addiction and concomitant hypertension were found to have higher levels of unfavourable outcomes; therefore such patients require continuous monitoring and support to ensure treatment success.