Perceived Social Support and Medication Dose Interruption Among Pulmonary Tuberculosis Patients in Western India: A Cross-Sectional Study

印度西部肺结核患者感知到的社会支持与药物剂量中断:一项横断面研究

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Abstract

Introduction Despite efforts, tuberculosis (TB) remains a major public health problem in developing countries, and India alone accounts for most of the global TB cases. Although the treatment for TB is highly successful, a significant number of TB patients in India do not complete their assigned treatment. Social support has a key influence on medication adherence for chronic illnesses like diabetes, asthma, HIV, hypertension, cardiovascular diseases, and TB. However, limited research in India focuses on patients' perceived social support and its association with medication dose interruption among pulmonary TB patients. This study aims to fill this gap and examine the association between perceived social support and medication dose interruption among pulmonary TB patients in Western India. Methods A cross-sectional study was conducted at three directly observed treatment, short-course (DOTS) centers in Bhiwandi City, Maharashtra state, in Western India. A total of 477 participants were recruited, and data on participants' medication dose interruptions in the last month, their clinical characteristics, and their perceived social support were collected. Descriptive and inferential statistics were applied. Results Perceived social support presented a significant association with TB medication dose interruption. Participants who reported low social support were significantly 2.6 times more likely to miss their doses in the last month (adjusted odds ratio (aOR) = 2.6 (95% confidence interval (CI): 1.556-4.403), P < 0.001). Participants who reported low family support were significantly 4.1 times more likely to miss their doses when compared with the participants who reported high family support (aOR = 4.1 (95% CI: 2.482-7.070), P < 0.001). Among the participants who missed their doses one to five times in the last month, those who reported low social support were significantly 2.5 times more likely to miss their doses, when compared with the participants who reported high social support (aOR = 2.5 (95% CI: 1.318-4.810), P = 0.005). Likewise, among the group of participants who missed their doses six or more times in the last month, those who reported low social support were significantly 3.1 times more likely to miss their doses, when compared with the participants who reported high social support (aOR = 3.1 (95% CI: 1.452-6.744), P = 0.004). Conclusion The study results underscore the importance of integrating patient-centered strategies into healthcare systems, ensuring that they not only offer social protection but also recognize social support as a critical component of TB treatment. This study could potentially inform various healthcare policymakers in formulating such patient-centric and focused intervention strategies by involving social networks and family dynamics.

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