IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0070064.html
   My bibliography  Save this article

Patterns of Treatment Interruption among Patients with Multidrug-Resistant TB (MDR TB) and Association with Interim and Final Treatment Outcomes

Author

Listed:
  • Laura Jean Podewils
  • Maria Tarcela S Gler
  • Maria Imelda Quelapio
  • Michael P Chen

Abstract

Background: The reasons that patients with multidrug-resistant tuberculosis (MDR TB) miss treatment are multi-factorial and complex. Identifying patterns of treatment interruption that predict poor outcomes can be used to target program activities aiming to improve treatment adherence. Objective: To characterize patterns of treatment interruption among MDR TB patients and determine the association between patterns and treatment outcomes. Methods: Retrospective analysis of MDR TB patients. A treatment interruption was defined as any time that a patient missed a prescribed dose of treatment for at least 1 day but for a period of less than 2 consecutive months. Patients were characterized by the number, length and variability of interruptions, variability of time between interruptions, and percent of missed doses. Final treatment outcome was dichotomized as a successful (cured or completed) or poor outcome (defaulted, failed, or died). Risk ratios were calculated to determine the association between characteristics of treatment interruption and treatment outcomes. All analyses were conducted in 6 month treatment intervals. Results: Only 7.0% of 583 patients completed treatment without interruption. Of the remaining 542 patients, the median time to the first interruption was 2 ½ months (70 days). In multivariate analysis, patients who had longer interruptions with sporadic variability during the 6–12 month or the 12–18 month treatment period had a significantly increased risk for poor outcomes compared to patients who had short, regular interruptions (RRadj 4.37, 95% CI 1.2–15.8; = 0.03 and RRadj 3.38, 95% CI 1.6–7.1; p = 0.001, respectively). In addition, missing 10% or more of the prescribed doses during any 6 month period in the initial 18 months of therapy significantly increased the risk for poor outcomes (RRadj range 1.55–2.35; p-value range 0.01–0.005). Conclusion: Patients that miss more consecutive days of treatment with sporadic interruption patterns or a greater proportion of treatment are at an increased risk for poor treatment outcomes.

Suggested Citation

  • Laura Jean Podewils & Maria Tarcela S Gler & Maria Imelda Quelapio & Michael P Chen, 2013. "Patterns of Treatment Interruption among Patients with Multidrug-Resistant TB (MDR TB) and Association with Interim and Final Treatment Outcomes," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-8, July.
    • Handle: RePEc:plo:pone00:0070064
    DOI: 10.1371/journal.pone.0070064
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070064
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0070064&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0070064?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. C. Fitzpatrick & K. Floyd, 2012. "Erratum to Systematic Reviewof the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 81-81, January.
    2. Deborah A Gust & Barudi Mosimaneotsile & Unami Mathebula & Balladiah Chingapane & Zaneta Gaul & Sherri L Pals & Taraz Samandari, 2011. "Risk Factors for Non-Adherence and Loss to Follow-Up in a Three-Year Clinical Trial in Botswana," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-9, April.
    3. Christopher Fitzpatrick & Katherine Floyd, 2012. "A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 63-80, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mehari Woldemariam Merid & Atalay Goshu Muluneh & Melaku Kindie Yenit & Getahun Molla Kassa, 2020. "Treatment interruption and associated factors among patients registered on drug-resistant tuberculosis treatment in Amhara regional state, Ethiopia: 2010–2017," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-10, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Senait Alemayehu & Amanuel Yigezu & Damen Hailemariam & Alemayehu Hailu, 2020. "Cost-effectiveness of treating multidrug-resistant tuberculosis in treatment initiative centers and treatment follow-up centers in Ethiopia," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-13, July.
    2. Sizulu Moyo & Helen S Cox & Jennifer Hughes & Johnny Daniels & Leigh Synman & Virginia De Azevedo & Amir Shroufi & Vivian Cox & Gilles van Cutsem, 2015. "Loss from Treatment for Drug Resistant Tuberculosis: Risk Factors and Patient Outcomes in a Community-Based Program in Khayelitsha, South Africa," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-13, March.
    3. Marian Loveday & Kristina Wallengren & Tarylee Reddy & Donela Besada & James C M Brust & Anna Voce & Harsha Desai & Jacqueline Ngozo & Zanele Radebe & Iqbal Master & Nesri Padayatchi & Emmanuelle Davi, 2018. "MDR-TB patients in KwaZulu-Natal, South Africa: Cost-effectiveness of 5 models of care," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-13, April.
    4. Eline L Korenromp & Philippe Glaziou & Christopher Fitzpatrick & Katherine Floyd & Mehran Hosseini & Mario Raviglione & Rifat Atun & Brian Williams, 2012. "Implementing the Global Plan to Stop TB, 2011–2015 – Optimizing Allocations and the Global Fund’s Contribution: A Scenario Projections Study," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-10, June.
    5. Catherine Pitt & Catherine Goodman & Kara Hanson, 2016. "Economic Evaluation in Global Perspective: A Bibliometric Analysis of the Recent Literature," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 9-28, February.
    6. Jude Beauchamp & Carole D. Mitnick & Hannah Gilbert & Fernet Leandre & Yoldine Talina Jean Noel & Walkens Desir & Christina Lively & Joia Mukherjee, 2021. "Ambulatory Treatment for Multidrug-Resistant Tuberculosis in Rural Haiti: A Mixed-Methods Study of Social and Economic Factors Affecting Timely Diagnosis and Treatment Success," Global Journal of Health Science, Canadian Center of Science and Education, vol. 13(7), pages 1-99, July.
    7. Roger Bate & Ginger Zhe Jin & Aparna Mathur, 2015. "Falsified or Substandard? Assessing Price and Non‐price Signals of Drug Quality," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 24(4), pages 687-711, October.
    8. Juliet N Sekandi & Kevin Dobbin & James Oloya & Alphonse Okwera & Christopher C Whalen & Phaedra S Corso, 2015. "Cost-Effectiveness Analysis of Community Active Case Finding and Household Contact Investigation for Tuberculosis Case Detection in Urban Africa," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-18, February.
    9. Titilola Makanjuola & Henock B Taddese & Andrew Booth, 2014. "Factors Associated with Adherence to Treatment with Isoniazid for the Prevention of Tuberculosis amongst People Living with HIV/AIDS: A Systematic Review of Qualitative Data," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-13, February.
    10. Roger Bate & Ginger Zhe Jin & Aparna Mathur, 2012. "Counterfeit or Substandard? Assessing Price and Non-Price Signals of Drug Quality," NBER Working Papers 18073, National Bureau of Economic Research, Inc.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0070064. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.