Adherence is associated with the quality of professional–patient interaction in Directly Observed Treatment Short-course, DOTS

• DOI: 10.1016/j.pec.2005.08.006
• Publication Date: 2005-10-20T14:20:38Z
• Authors: Pranaya Mishra; Ebba Holme Hansen; Svend Sabroe; Kumud Kumar Kafle
• Keywords: Questionnaires; Adult; Male; Health Knowledge, Attitudes, Practice; Adolescent; Antitubercular Agents; 03 medical and health sciences; 0302 clinical medicine; Nepal; Patient Education as Topic; Risk Factors; Tuberculosis; Humans; Aged; Practice; Health Services Needs and Demand; Health Knowledge; Communication; Professional-Patient Relations; Middle Aged; Directly Observed Therapy; 3. Good health; Logistic Models; Attitudes; Case-Control Studies; Multivariate Analysis; Patient Compliance; Female; Clinical Competence; Psychological Theory

To investigate the association between the behaviour of health professionals as reported by patients, the quality of communication, patients' communication about their disease, and non-adherence to Directly Observed Tuberculosis Treatment Short-course, DOTS.This study was designed as a case-control study based on 50 cases (non-adherents) and 100 controls (adherents), conducted in a hilly western district in Nepal. The participation rate was 80% for 50 cases and 95% for 100 controls. All covariates with p-value<or=0.2 were included in a multivariate logistic regression model to identify the factors significantly associated with treatment non-adherence.The analysis identified that poor-grade communication (OR=11.2; CI 2.5-50.4) and fair-grade communication (OR=2.7; CI 1.2-6.3) between patients and dispensers were significantly associated with non-adherence.Better communication between health professionals, particularly dispensers, and patients is essential for improving treatment adherence in TB treatment, even under DOTS.Drug dispensers should be trained to develop their communication skills about the use of medications, associated side effects, benefits and risk of non-adherence, as well as to respect the individual patient's autonomy and integrity.