In search of factors responsible for noncompliance among tuberculosis patients in Wardha District, India

From September 1988 to February 1989 52 compliant and 50 noncompliant tuberculosis outpatients who were prescribed antituberculosis drug regimens were interviewed in Wardha District, India. Patients were compared by means of a questionnaire with previously fixed response options in order to identify which factors were responsible for having complied or not. Discriminant analysis demonstrated differences between completers and noncompleters on several health belief items, in particular those regarding health motivation, the perceived severity of the disease, costs and benefits of the treatment regimen and self-efficacy. Compliers reported more physical symptoms at the onset of the disease, whereas more noncompliers mentioned a deteriorated health condition at the time of interviewing. Low associations were found between demographic and socioeconomic variables and adherence, except for some indicators of income level. The relationship between presence of social support and cooperation with the treatment procedure was confirmed. An indication of an educational problem was the association between the compliance behaviour of a patient and his or her knowledge of specific aspects of the disease, the origin of tuberculosis and features of the drug regimen. Satisfaction with the health care provider contributed positively to the continuation of drug intake.