“ADHERENCE TO 2ND LINE ANTI-TUBERCULAR DRUGS IN DRUG-RESISTANT TUBERCULOSIS CASES”
Main Article Content
Keywords
adherence, drug-resistant tuberculosis, Morisky medication adherence scale
Abstract
India aims to end tuberculosis (TB) by 2025.So we need to have high adherence to anti-TB drugs. We conducted this study to know the adherence to second line drugs for drug-resistant TB. It was a prospective-observational study conducted from November 2022 to May 2024. After obtaining informed consent from the patients, we noted their demographic profile and treatment was started by the chest physicians (not the investigator) as per the guidelines of Revised National TB Control Program PMDT (programmatic management of drug-resistant TB). Patients were followed on a monthly basis for six months, either telephonically or whenever they came for collecting monthly medicines. To assess the level of adherence, we used the eight-item Morisky Medication Adherence Scale (MMAS-8) questionnaire. 228 patients were registered as drug-resistant TB cases at our institute. Of these, 199 were enrolled in the study as per the inclusion and exclusion criteria. There were 9 drop-outs and only 190 patients were considered for final statistical analysis. We found that with the advancement of time, the adherence to second line drugs for drug-resistant TB decreased despite all follow-ups. We concluded that proper patient counseling is important during follow-ups or during monthly visits of patients for collection of their medications. We need to have strategies which are adaptable and people-centered so as to increase the adherence to these drugs and can add to a better outcome.
References
2. Irfani TH, Siburian R, Nabila R, Umar TP. Tuberculosis and Coronavirus Disease 2019 (COVID-19) from A Clinical Perspective: A Systematic Review. Medeni Med J. 2020;35(4):338.
3. Sakula A. Robert Koch: centenary of the discovery of the tubercle bacillus, 1882. Thorax. 1982 Apr;37(4):246–51.
4. Beloor Suresh A, Rosani A, Patel P, Wadhwa R. Rifampin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Jun 25]. Available from: http://www.ncbi.nlm. nih.gov/books/NBK557488/
5. Lee N, Patel P, Nguyen H. Ethambutol. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Jun 25]. Available from: http://www.ncbi.nlm.nih.gov/ books/NBK559050/
6. O’Connor C, Patel P, Brady MF. Isoniazid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Jun 25]. Available from: http://www.ncbi.nlm.nih.gov/ books/NBK557617/
7. Finci I, Albertini A, Merker M, Andres S, Bablishvili N, Barilar I, et al. Investigating resistance in clinical Mycobacterium tuberculosis complex isolates with genomic and phenotypic antimicrobial susceptibility testing: a multicentre observational study. Lancet Microbe. 2022 Sep;3(9):e672–82.
8. Mahata G, T. A RK, Sen P, Mukhopadhyay S. A Study on Adverse Drug Reaction Profile of 2nd Line Drugs in Multi Drug Resistant (MDR) and Extensively Drug Resistant (XDR) Tuberculosis Cases Registered under DR-TB Centre in a Tertiary Care Hospital. J Evol Med Dent Sci. 2020 Feb 3;9(05):280–3.
9. 2.3 Drug-resistant TB [Internet]. [cited 2024 Jan 24]. Available from: https://www.who. int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022/tb-disease-burden/2-3-drug-resistant-tb
10. 1.1 TB incidence [Internet]. [cited 2024 Jul 18]. Available from: https://www.who.int/ teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023/tb-disease-burden/1-1-tb-incidence
11. WHO consolidated guidelines on tuberculosis. Module 4, Treatment: drug-resistant tuberculosis treatment. 2022 update. Geneva, Switzerland: World Health Organization; 2022.
12. Park. K. Park’s textbook of Preventive and Social Medicine.Twenty seventh edition. Jabalpur:M/s-Banarsidas Bhanot;2023
13. Jimmy B, Jose J. Patient Medication Adherence: Measures in Daily Practice. Oman Med J. 2011 May;26(3):155–9.
14. Moharamzad Y, Saadat H, Shahraki BN, Rai A, Saadat Z, Aerab-Sheibani H, et al. Validation of the Persian Version of the 8-Item Morisky Medication Adherence Scale (MMAS-8) in Iranian Hypertensive Patients. Glob J Health Sci. 2015 Jul;7(4):173–83.
15. Anghel LA, Farcas AM, Oprean RN. An overview of the common methods used to measure treatment adherence. Med Pharm Rep. 2019 Apr;92(2):117–22.
16. Sharma D, Goel NK, Cheema YS, Garg K. Medication Adherence and its Predictors among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Indian J Community Med Off Publ Indian Assoc Prev Soc Med. 2023;48(5):781–5.
17. Janežič A, Locatelli I, Kos M. Criterion validity of 8-item Morisky Medication Adherence Scale in patients with asthma. PLoS ONE. 2017 Nov 30;12(11):e0187835.
18. Baig MS, Kale MR, Lamb A. A prospective observational pharmacovigilance study of adverse drug reaction monitoring in patients of MDR-TB at tertiary care hospital. Int J Basic Clin Pharmacol. 2018 Jun 22;7(7):1291.
19. Massud A, Syed Sulaiman SA, Ahmad N, Shafqat M, Chiau Ming L, Khan AH. Frequency and Management of Adverse Drug Reactions Among Drug-Resistant Tuberculosis Patients: Analysis From a Prospective Study. Front Pharmacol [Internet]. 2022 Jun 2 [cited 2024 Jun 19];13. Available from: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.883483/full
20. Matreja PS, Garg R, Maqusood M. Pharmacovigilance monitoring and treatment adherence in patients on anti-tubercular drugs. Indian J Tuberc. 2023 Oct 1;70(4):409–15.
21. Ravichandran M, Rajaram M, Munusamy M. Pharmacovigilance of Antitubercular Therapy in Tuberculosis. Cureus [Internet]. 2022 Feb 4 [cited 2023 Oct 8]; Available from: https://www.cureus.com/articles/82435-pharmacovigilance-of-antitubercular-therapy-in-tuberculosis
22. Dhamotharaswamy K, Selvaraj H, Chidambaram K, Dhanasekaran M, Duraisamy K, Khan NA, et al. An impactful prospective study on pulmonary tuberculosis in geriatric populations besides its clinical outcomes and implications in the Indian subcontinent.
23. Kalva J, Babu SP, Narasimhan PB, Raghupathy K, Ezhumalai K, Knudsen S, et al. Predictors of weight loss during the intensive phase of tuberculosis treatment in patients with drug-susceptible pulmonary tuberculosis in South India. J Public Health Oxf Engl. 2022 Nov 30;45(3):545–52.
24. Chen MY, Lo YC, Chen WC, Wang KF, Chan PC. Recurrence after Successful Treatment of Multidrug-Resistant Tuberculosis in Taiwan. PLoS ONE. 2017 Jan 26;12(1):e0170980.
25. Yang Q, Han J, Shen J, Peng X, Zhou L, Yin X. Diagnosis and treatment of tuberculosis in adults with HIV. Medicine (Baltimore). 2022 Sep 2;101(35):e30405.
26. Boadu AA, Yeboah-Manu M, Osei-Wusu S, Yeboah-Manu D. Tuberculosis and diabetes mellitus: The complexity of the comorbid interactions. Int J Infect Dis [Internet]. 2024 Jun 14 [cited 2024 Jun 29];0(0). Available from: https://www.ijidonline.com/article/S1201-9712(24)00211-X/fulltext
27. Hochberg NS, Sarkar S, Horsburgh CR, Knudsen S, Pleskunas J, Sahu S, et al. Comorbidities in pulmonary tuberculosis cases in Puducherry and Tamil Nadu, India: Opportunities for intervention. PLoS ONE. 2017 Aug 23;12(8):e0183195.
28. Salindri AD, Auld SC, Gujral UP, Urbina EM, Andrews JR, Huaman MA, et al. Tuberculosis infection and hypertension: Prevalence estimates from the US National Health and Nutrition Examination Survey. medRxiv. 2023 May 16;2023.05.12.23289899.
29. Mandieka E, Saleh D, Chokshi AK, Rivera AS, Feinstein MJ. Latent Tuberculosis Infection and Elevated Incidence of Hypertension. J Am Heart Assoc Cardiovasc Cerebrovasc Dis. 2020 Dec 2;9(24):e019144.
30. Thomas BE, Thiruvengadam K, S. R, Kadam D, Ovung S, Sivakumar S, et al. Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored. PLoS ONE. 2019 Jul 31;14(7):e0220507.
31. Tewatia P, Kaushik RM, Kaushik R, Kumar S. Tobacco smoking as a risk factor for tuberculous pleural effusion: a case-control study. Glob Health Epidemiol Genomics. 5:e1.
32. Modi B, Modha J. Spectrum of anti tubercular therapy induced cutaneous adverse drug reactions and its management through rechallenge: A prospective study at a Tertiary Care Centre. Indian J Tuberc. 2022 Oct;69(4):470–5.
33. Nellums LB, Rustage K, Hargreaves S, Friedland JS. Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis. BMC Med. 2018 Feb 22;16:27.
34. Stephens F, Gandhi NR, Brust JCM, Mlisana K, Moodley P, Allana S, et al. Treatment Adherence among Persons Receiving Concurrent Multidrug-Resistant Tuberculosis and Human Immunodeficiency Virus Treatment in KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr 1999. 2019 Oct 1;82(2):124–30.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. PrernaJ. Kerketta
Department of Pharmacology, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Dr. Hemlata Verma
Department of Pharmacology, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Dr. Lokendra Dave
Department of Respiratory Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Dr. Vishwas Gupta
Department of Respiratory Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Dr J. L. Marko
Department of Pharmacology, Gandhi Medical College, Bhopal, Madhya. Pradesh, India.