Identifying and Addressing Factors Contributing to Pretreatment Loss to Follow-Up of Tuberculosis Patients Referred for Treatment from Medical Colleges in Pondicherry: An Implementation Research.
Lost to follow-up
qualitative research
quasi-experimental studies
risk factors
tuberculosis
Journal
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
ISSN: 0970-0218
Titre abrégé: Indian J Community Med
Pays: India
ID NLM: 9315574
Informations de publication
Date de publication:
Historique:
entrez:
8
2
2020
pubmed:
8
2
2020
medline:
8
2
2020
Statut:
ppublish
Résumé
In India, there is no feedback regarding 34% of tuberculosis (TB) patients diagnosed and referred from medical colleges for treatment to peripheral health institutions (PHIs). The aim of this study is to measure the effectiveness of the new intervention package, developed based on qualitative study in reducing pretreatment loss to follow-up (PTLFU) of all TB patients diagnosed and referred for treatment from medical colleges to PHIs. An intervention was developed based on the findings of in depth-interviews conducted among different stakeholders such as TB patients who did/did not report, service providers working in four medical colleges in Pondicherry. Intervention consisting of phone calls, home visits, etc., was implemented for a period of 6 months. The baseline and endline proportion of TB patients for whom feedback received was determined from the available records (Revised National TB Control Program State Task Force Quarterly reports). Patient's ignorance, lack of faith in healthcare system, side effects and social stigma, unpleasant experience in hospitals, poor accessibility to directly observed treatment, short-course centers, drugs shortage, poor coordination between program and hospital staff were the risk factors for PTLFU. At baseline, the proportions of feedback received about TB patients referred for treatment from medical colleges to PHIs was 46%. After the initiation of interventions, it increased to 61% and 66% in the first and second quarters of 2017, respectively. Risk factors for PTLFU were multi-factorial related to both patient and health system. Simple, feasible interventions such as phone calls and home visits to TB patients were effective in reducing PTLFU.
Sections du résumé
BACKGROUND
BACKGROUND
In India, there is no feedback regarding 34% of tuberculosis (TB) patients diagnosed and referred from medical colleges for treatment to peripheral health institutions (PHIs).
OBJECTIVES
OBJECTIVE
The aim of this study is to measure the effectiveness of the new intervention package, developed based on qualitative study in reducing pretreatment loss to follow-up (PTLFU) of all TB patients diagnosed and referred for treatment from medical colleges to PHIs.
MATERIALS AND METHODS
METHODS
An intervention was developed based on the findings of in depth-interviews conducted among different stakeholders such as TB patients who did/did not report, service providers working in four medical colleges in Pondicherry. Intervention consisting of phone calls, home visits, etc., was implemented for a period of 6 months. The baseline and endline proportion of TB patients for whom feedback received was determined from the available records (Revised National TB Control Program State Task Force Quarterly reports).
RESULTS
RESULTS
Patient's ignorance, lack of faith in healthcare system, side effects and social stigma, unpleasant experience in hospitals, poor accessibility to directly observed treatment, short-course centers, drugs shortage, poor coordination between program and hospital staff were the risk factors for PTLFU. At baseline, the proportions of feedback received about TB patients referred for treatment from medical colleges to PHIs was 46%. After the initiation of interventions, it increased to 61% and 66% in the first and second quarters of 2017, respectively.
CONCLUSION
CONCLUSIONS
Risk factors for PTLFU were multi-factorial related to both patient and health system. Simple, feasible interventions such as phone calls and home visits to TB patients were effective in reducing PTLFU.
Identifiants
pubmed: 32029980
doi: 10.4103/ijcm.IJCM_118_19
pii: IJCM-45-27
pmc: PMC6985961
doi:
Types de publication
Journal Article
Langues
eng
Pagination
27-31Informations de copyright
Copyright: © 2020 Indian Journal of Community Medicine.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Indian J Tuberc. 2007 Jan;54(1):12-6
pubmed: 17455418
PLoS One. 2010 Jan 25;5(1):e8873
pubmed: 20111727
Indian J Med Res. 2013 Feb;137(2):283-94
pubmed: 23563371
Int J Tuberc Lung Dis. 2002 Sep;6(9):780-8
pubmed: 12234133
Int J Tuberc Lung Dis. 2009 Jul;13(7):801-3
pubmed: 19555527
Indian J Tuberc. 2007 Apr;54(2):66-70
pubmed: 17575677
Indian J Tuberc. 2007 Jul;54(3):130-5
pubmed: 17886701
Trans R Soc Trop Med Hyg. 2013 Sep;107(9):558-65
pubmed: 23920324
Natl Med J India. 2004 Nov-Dec;17(6):292-9
pubmed: 15736548