Assessment of adherence to anti tuberculosis medication for successful implementation of revised national tuberculosis programme at a tertiary care hospital, Shimoga: a cross-sectional observational study

ABSTRACT

Background: This study assessed level of non-adherence to anti tuberculosis (TB) therapy among pulmonary TB patients, compares various factors among adherent and non-adherent TB patients, stressing on reasons for non-adherence at a tertiary care hospital.Methods: This institution based observational and cross-sectional study was conducted interviewing patients with pulmonary TB and assessed using Moriskys medication adherence scale-8 (MMAS-8), a pre- tested structured questionnaire based scoring system of patients treated for pulmonary TB at district TB centre SIMS, Shimoga. Descriptive statistics were employed.Results: Among 70 cases analysed, 57 were males and 13 females, with mean age group of 41.32�63 and mean MMAS score of 2.23�87. 53.33% patients were on continuous phase of treatment. The level of non-adherence were as follows, high= 18%, medium= 38% and low= 44%. The common cause for non-adherence was forgetfulness (66%) reasons being betterment of symptoms (54%), sickness after taking medication (31%), distance of travel far (15%). Many were labourers (62%), with low literacy rate, also chronic alcoholics (72%) and smokers (73%). Female with moderate literacy and not addicted to alcohol/smoking showed high adherence compared to males (p<0.05%).Conclusions: As prevalence of non-adherence is high, especially Patients on continuous phase of TB treatment, there arises immense need for continuous and effective health education to patients� and their family regarding the adverse effects and the need for high level of adherence to treatment for the complete cure of disease. Patients who are addicted to alcohol/smoking should be targeted with interventions to quit the same, provide free transport facility to RNTCP centres and prompt treatment of ADR, will improve adherence to medication.