Assessment of Medication Adherence to Anti-tuberculosis Treatment Among Patients With Tuberculosis at a Tertiary Care Hospital in South Gujarat, India

印度古吉拉特邦南部一家三级医院结核病患者抗结核治疗药物依从性评估

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Abstract

Background Tuberculosis (TB) remains a major public health challenge, especially in developing countries like India. A successful TB treatment relies heavily on good medication adherence, which helps to prevent complications such as drug resistance and poor treatment outcomes. Multiple factors influence medication adherence, including socioeconomic, patient-related, and therapy-related aspects. Objectives This study aims to assess the level of medication adherence and factors affecting medication adherence in TB patients during treatment. Methodology A cross-sectional observational study was conducted among 223 TB patients (≥18 years) who had received more than two months of anti-TB treatment in a tertiary care hospital. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Data were analysed based on demographic and clinical variables using IBM SPSS Statistics for Windows, V. 30.0 (IBM Corp., Armonk, NY, USA). Results Among 223 patients, 126 (56.5%) were male and 97 (43.5%) were female with a mean age of 35.08 ± 13.28 years. Using MMAS-8 to analyse medication adherence levels, 150 (67%) patients showed high medication adherence, 41 (18%) medium, and 32 (15%) low. High medication adherence was more prevalent among 70 (72.16%) females as compared to 80 (63.49%) males. Medication adherence was similar between 92 drug-sensitive TB (67.6% high medication adherence) and 58 drug-resistant TB (66.7% high medication adherence) cases. The most common factors affecting medication adherence were difficulty in procurement of medicines, lack of family support, and misunderstanding of treatment schedules. The most frequently reported adverse drug reaction was gastrointestinal upset (60, 46.9%), followed by neuropathy (22, 17.2%) and arthralgia (15, 11.7%). Conclusion The study showed good medication adherence among TB patients, supported by programmatic measures. Maintaining and enhancing medication adherence still requires addressing financial obstacles, enhancing medication availability, and monitoring and managing adverse reactions.

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