[Practical issues in the management of tuberculosis disease]

Area of Science:

• Public Health
• Infectious Diseases
• Medical Guidelines

Background:

• Tuberculosis (TB) management requires adherence to standard therapeutic guidelines.
• The High Authority for Health (HAS) provides guidelines for TB treatment in France.

Purpose of the Study:

• To assess the adherence to standard tuberculosis treatment guidelines.
• To identify deviations from recommended care pathways and treatment protocols.

Main Methods:

• A national survey was conducted by the medical services of the régime social des indépendants (RSI).
• Patients reimbursed for TB treatment or admitted for long-term TB in 2011 were targeted.
• Physicians were contacted to detail patient care pathways and treatments received.

Main Results:

• Out of 148 TB patients, 71.6% had respiratory TB; 84.5% were diagnosed in healthcare institutions.
• Standard treatment (phases 1 and 2) was used in only 30.1% of cases.
• Adherence to recommended quadruple therapy in phase 1 was 55.2%, and timely administration was 62.9%; phase 2 adherence was 80.4%, with duration respected in 51.0%.

Conclusions:

• The survey revealed a relative lack of knowledge regarding standard TB treatment as recommended by the HAS.
• Deviations from standard treatment were infrequently explained by detected health or social events (39.0%).