Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study
Objectives To understand the challenges faced by patients with tuberculosis (TB) and factors that influence TB treatment adherence in Ukraine.Design Qualitative study.Setting TB treatment facilities in Kyiv Oblast, Ukraine.Participants Sixty adults who had undergone treatment for drug-sensitive TB b...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/1/e032027.full |
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| author | Omowunmi Aibana Emily Dauria Tetiana Kiriazova Olena Makarenko Mariya Bachmaha Natasha Rybak Timothy Palen Flanigan Vasyl Petrenko Anne E Becker |
| author_facet | Omowunmi Aibana Emily Dauria Tetiana Kiriazova Olena Makarenko Mariya Bachmaha Natasha Rybak Timothy Palen Flanigan Vasyl Petrenko Anne E Becker |
| author_sort | Omowunmi Aibana |
| collection | DOAJ |
| description | Objectives To understand the challenges faced by patients with tuberculosis (TB) and factors that influence TB treatment adherence in Ukraine.Design Qualitative study.Setting TB treatment facilities in Kyiv Oblast, Ukraine.Participants Sixty adults who had undergone treatment for drug-sensitive TB between June 2012 and August 2015.Methods We conducted semistructured, in-depth, individual interviews among a purposively selected clinical sample of patients previously treated for drug-sensitive TB. Interview content encompassed WHO’s framework for barriers to adherence to long-term therapies and included questions about patient preferences and motivators concerning treatment adherence. We examined treatment experience across strata defined by previously identified risk correlates of non-adherence.Results Among 60 participants, 19 (32.8%) were HIV positive, 12 (20.3%) had substance use disorder and 9 (15.0%) had not completed TB treatment. Respondents discussed the psychological distress associated with hospital-based TB care, as well as perceived unsupportive, antagonistic interactions with TB providers as major challenges to treatment adherence. An additional barrier to successful treatment completion included the financial toll of lost income during TB treatment, which was exacerbated by the additional costs of ancillary medications and transportation to ambulatory TB clinics. The high pill burden of TB treatment also undermined adherence. These challenges were endorsed among participants with and without major risk factors for non-adherence.Conclusions Our findings highlight important barriers to TB treatment adherence in this study population and suggest specific interventions that may be beneficial in mitigating high rates of poor treatment outcomes for TB in Ukraine. |
| format | Article |
| id | doaj-art-7ca93aeca13b4e059e2e36fdfd7e9a09 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7ca93aeca13b4e059e2e36fdfd7e9a092025-08-20T02:20:58ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-032027Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative studyOmowunmi Aibana0Emily Dauria1Tetiana Kiriazova2Olena Makarenko3Mariya Bachmaha4Natasha Rybak5Timothy Palen Flanigan6Vasyl Petrenko7Anne E Becker81 Internal Medicine, McGovern Medical School at the University of Texas Health Science Center - Houston, Houston, Texas, USA2 Psychiatry, University of California San Francisco, San Francisco, California, USA3 Ukrainian Institute on Public Health Policy, Kyiv, Ukraine3 Ukrainian Institute on Public Health Policy, Kyiv, Ukraine4 PH Capital. Public Health Experts, Kyiv, Ukraine5 Infectious Diseases, The Miriam Hospital, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA5 Infectious Diseases, The Miriam Hospital, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA6 Phthisiology (Tuberculosis), Bogomolets National Medical University, Kyiv, Ukraine7 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USAObjectives To understand the challenges faced by patients with tuberculosis (TB) and factors that influence TB treatment adherence in Ukraine.Design Qualitative study.Setting TB treatment facilities in Kyiv Oblast, Ukraine.Participants Sixty adults who had undergone treatment for drug-sensitive TB between June 2012 and August 2015.Methods We conducted semistructured, in-depth, individual interviews among a purposively selected clinical sample of patients previously treated for drug-sensitive TB. Interview content encompassed WHO’s framework for barriers to adherence to long-term therapies and included questions about patient preferences and motivators concerning treatment adherence. We examined treatment experience across strata defined by previously identified risk correlates of non-adherence.Results Among 60 participants, 19 (32.8%) were HIV positive, 12 (20.3%) had substance use disorder and 9 (15.0%) had not completed TB treatment. Respondents discussed the psychological distress associated with hospital-based TB care, as well as perceived unsupportive, antagonistic interactions with TB providers as major challenges to treatment adherence. An additional barrier to successful treatment completion included the financial toll of lost income during TB treatment, which was exacerbated by the additional costs of ancillary medications and transportation to ambulatory TB clinics. The high pill burden of TB treatment also undermined adherence. These challenges were endorsed among participants with and without major risk factors for non-adherence.Conclusions Our findings highlight important barriers to TB treatment adherence in this study population and suggest specific interventions that may be beneficial in mitigating high rates of poor treatment outcomes for TB in Ukraine.https://bmjopen.bmj.com/content/10/1/e032027.full |
| spellingShingle | Omowunmi Aibana Emily Dauria Tetiana Kiriazova Olena Makarenko Mariya Bachmaha Natasha Rybak Timothy Palen Flanigan Vasyl Petrenko Anne E Becker Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study BMJ Open |
| title | Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study |
| title_full | Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study |
| title_fullStr | Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study |
| title_full_unstemmed | Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study |
| title_short | Patients’ perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study |
| title_sort | patients perspectives of tuberculosis treatment challenges and barriers to treatment adherence in ukraine a qualitative study |
| url | https://bmjopen.bmj.com/content/10/1/e032027.full |
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