Patient and provider preferences for long-acting TB preventive therapy

Area of Science:

• Public Health
• Infectious Diseases
• Pharmaceutical Sciences

Background:

• Tuberculosis preventive therapy (TPT) is crucial for TB elimination but faces challenges with underutilization.
• Long-acting (LA) formulations of TPT offer potential improvements in patient adherence and treatment outcomes.

Purpose of the Study:

• To evaluate patient preferences and concerns regarding various long-acting (LA) formulations for tuberculosis preventive therapy (TPT).
• To assess the perceived implementation feasibility of LA-TPT among healthcare providers (HCPs) in low- and middle-income countries (LMICs).

Main Methods:

• A cross-sectional in-person survey was conducted with 409 patients in India and South Africa, comparing oral pills to LA injections, implants, and microarray patches (MAPs).
• A parallel online survey of 94 HCPs in LMICs assessed the feasibility of implementing LA-TPT.
• Data were analyzed using descriptive statistics.

Main Results:

• Injectable LA-TPT was the most preferred formulation among patients (75% willingness to try), followed by pills, implants, and MAPs.
• Healthcare providers favored injectable LA-TPT (43%), followed by oral pills (26%).
• Patient concerns focused on potential inefficacy and prolonged side effects, while HCPs identified cost as a significant adoption barrier.

Conclusions:

• Injectable LA-TPT demonstrates high acceptability among patients and feasibility among HCPs.
• Addressing concerns related to cost, effectiveness, and safety is essential for successful implementation and wider adoption of LA-TPT.