Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia?
Introduction: Adherence to second-line antituberculosis drug is challenging. A combination of strategies needs to be implemented to achieve adherence. In Georgia an optimized adherence support (OAS) – a package of education, psychosocial support and adherence counselling – was added to the already...
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The Journal of Infection in Developing Countries
2021-09-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/13783 |
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| author | Tinatin Jomidava Mohammed Khogali Yuliia Sereda Zaza Avaliani Malkhaz Davitashvili Mikheil Madzgharashvili Nestan Tukvadze Lali Chaphurishvili Mamuka Chincharauli Maia Kipiani |
| author_facet | Tinatin Jomidava Mohammed Khogali Yuliia Sereda Zaza Avaliani Malkhaz Davitashvili Mikheil Madzgharashvili Nestan Tukvadze Lali Chaphurishvili Mamuka Chincharauli Maia Kipiani |
| author_sort | Tinatin Jomidava |
| collection | DOAJ |
| description |
Introduction: Adherence to second-line antituberculosis drug is challenging. A combination of strategies needs to be implemented to achieve adherence. In Georgia an optimized adherence support (OAS) – a package of education, psychosocial support and adherence counselling – was added to the already existing package of adherence support (supervised treatment, adherence incentives, transport cost reimbursement) to improve adherence and increase treatment success. We assessed the additive benefits of OAS on adherence and treatment outcomes.
Methodology: This was a before and after cohort study using routine programme data in the National Center for Tuberculosis and Lung Diseases in Tbilisi. All adult rifampicin- and multidrug-resistant tuberculosis (RR/MDR-TB) patients enrolled for treatment under directly observed therapy in the NCTLD during the period before (June 2015 – January 2016) and after (June 2017 – January 2018) were included in the study. Primary outcomes were: i) adequate adherence defined as ≥ 85% of days covered by TB medication during the whole treatment period; ii) final treatment outcomes.
Results: Of 221 RR/MDR-TB, most patients were male (76%, N = 167) with a mean age of 41 ± 14 years. Adherence data was available for 111 patients in the ‘before’ and 97 patients in the ‘after’ cohort. Adequate adherence was achieved by 62% (69/111) in the ‘before’ and 70% (68/97) in the ‘after’ cohort (p = 0.290). Overall treatment success was 64% (73/114) and 63% (67/107) in the ‘before’ and ‘after’ cohorts respectively (p = 0.937).
Conclusions: Implementation of OAS had modest effect on adherence and had no additive benefits on treatment outcomes among RR/MDR-TB patients on 18-20 months regimen.
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| format | Article |
| id | doaj-art-e5e8fdaadf8f48159f5a3a43b37813ff |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-e5e8fdaadf8f48159f5a3a43b37813ff2025-08-20T03:48:46ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-09-011509.110.3855/jidc.13783Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia?Tinatin Jomidava0Mohammed Khogali1Yuliia Sereda2Zaza Avaliani3Malkhaz Davitashvili4Mikheil Madzgharashvili5Nestan Tukvadze6Lali Chaphurishvili7Mamuka Chincharauli8Maia Kipiani9National Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaUNICEF / UNDP / World Bank / WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, SwitzerlandJoint Tuberculosis, HIV and Viral Hepatitis Program, Division of Health Emergencies and Communicable Diseases, WHO Regional Office for Europe, Copenhagen, DenmarkNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, GeorgiaNational Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia Introduction: Adherence to second-line antituberculosis drug is challenging. A combination of strategies needs to be implemented to achieve adherence. In Georgia an optimized adherence support (OAS) – a package of education, psychosocial support and adherence counselling – was added to the already existing package of adherence support (supervised treatment, adherence incentives, transport cost reimbursement) to improve adherence and increase treatment success. We assessed the additive benefits of OAS on adherence and treatment outcomes. Methodology: This was a before and after cohort study using routine programme data in the National Center for Tuberculosis and Lung Diseases in Tbilisi. All adult rifampicin- and multidrug-resistant tuberculosis (RR/MDR-TB) patients enrolled for treatment under directly observed therapy in the NCTLD during the period before (June 2015 – January 2016) and after (June 2017 – January 2018) were included in the study. Primary outcomes were: i) adequate adherence defined as ≥ 85% of days covered by TB medication during the whole treatment period; ii) final treatment outcomes. Results: Of 221 RR/MDR-TB, most patients were male (76%, N = 167) with a mean age of 41 ± 14 years. Adherence data was available for 111 patients in the ‘before’ and 97 patients in the ‘after’ cohort. Adequate adherence was achieved by 62% (69/111) in the ‘before’ and 70% (68/97) in the ‘after’ cohort (p = 0.290). Overall treatment success was 64% (73/114) and 63% (67/107) in the ‘before’ and ‘after’ cohorts respectively (p = 0.937). Conclusions: Implementation of OAS had modest effect on adherence and had no additive benefits on treatment outcomes among RR/MDR-TB patients on 18-20 months regimen. https://jidc.org/index.php/journal/article/view/13783drug-resistant tuberculosisadherencetreatment outcomesbefore-and-after studySORT IT |
| spellingShingle | Tinatin Jomidava Mohammed Khogali Yuliia Sereda Zaza Avaliani Malkhaz Davitashvili Mikheil Madzgharashvili Nestan Tukvadze Lali Chaphurishvili Mamuka Chincharauli Maia Kipiani Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? Journal of Infection in Developing Countries drug-resistant tuberculosis adherence treatment outcomes before-and-after study SORT IT |
| title | Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? |
| title_full | Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? |
| title_fullStr | Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? |
| title_full_unstemmed | Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? |
| title_short | Does optimized adherence support improve treatment outcomes in RR / MDR-TB patients on 18-20 months regimen in Tbilisi, Georgia? |
| title_sort | does optimized adherence support improve treatment outcomes in rr mdr tb patients on 18 20 months regimen in tbilisi georgia |
| topic | drug-resistant tuberculosis adherence treatment outcomes before-and-after study SORT IT |
| url | https://jidc.org/index.php/journal/article/view/13783 |
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