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Interventions for promoting adherence to tuberculosis management.

J Volmink1, P Garner

  • 1South African Cochrane Centre, Medical Research Council, PO Box 19070, Tygerberg, SOUTH AFRICA, 7505. cochrane@eagle.mrc.ac.sa

The Cochrane Database of Systematic Reviews
|October 18, 2000
PubMed
Summary
This summary is machine-generated.

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Improving tuberculosis treatment adherence is crucial as many patients do not complete their regimens. Interventions like reminder cards and incentives show promise in enhancing treatment completion and diagnostic protocol adherence.

Area of Science:

  • Public Health
  • Infectious Disease Management
  • Clinical Trial Research

Background:

  • High rates of non-completion for tuberculosis (TB) treatment, up to 50%, necessitate strategies to improve patient adherence.
  • Effective adherence to diagnostic and treatment protocols is vital for successful TB control and prevention.

Purpose of the Study:

  • To evaluate the efficacy of diverse interventions designed to enhance patient adherence to anti-tuberculosis treatment.
  • To assess the impact of interventions on the completion rates of tuberculosis diagnostic protocols.

Main Methods:

  • Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
  • Comprehensive literature search across multiple databases (Cochrane, Medline, Embase, Lilacs) and expert consultation.

Related Experiment Videos

  • Independent data extraction and quality assessment by two reviewers.

    • Main Results:

    • Reminder cards, combined incentives with health education, and enhanced clinic staff supervision improved TB treatment completion.
    • Intensive counseling/education showed no benefit in one trial; direct observation yielded mixed results on clinical outcomes.
    • Monetary incentives, lay health worker assistance, contracts, and telephone prompts improved return for tuberculin skin test reading.

    Conclusions:

    • Specific interventions demonstrate effectiveness in improving adherence to anti-tuberculosis therapy and diagnostic protocols.
    • Healthcare providers should consider implementing evidence-based interventions tailored to local contexts.
    • Prioritize future research in low-income countries, focusing on measuring both adherence and clinical outcomes.