Treatment Compliance of Multidrug Resistant Tuberculosis in Uzbekistan: Does Practice Follow Policy?
Ruzilya UsmanovaNargiza ParpievaHayk DavtyanOlga DenisiukJamshid GadoevSevak AlaverdyanKonstantin DumchevIrina LiverkoBarno AbdusamatovaPublished in: International journal of environmental research and public health (2021)
Compliance with treatment guidelines is essential to achieve successful outcomes in tuberculosis patients. Thus, we assessed if multidrug-resistant tuberculosis treatment practices from 2012-2018 in Uzbekistan were compliant with national guidelines in terms of regimens prescribed, weight-based drug dosages used, and documentation of treatment changes (such as prolongation of intensive phase, change of drugs, and their reasons) in the treatment card and Consilium form. A total of 1481 patients were included. Of them, only 25% received standardized regimens as per guidelines and the remaining received individualized regimens. There was an increasing trend in using standardized regimens from 2% in 2012 to 44% in 2018. Compliance to recommended weight-based drug dosages was observed in 85% of the patients during the intensive phase and 84% in the continuation phase-ranged 71-91% over the years. Prolongation of the intensive phase was done in 42% of patients. The treatment was changed in 44% of patients during the intensive phase and 34% of patients during the continuation phase. The documentation of treatment changes was suboptimal (42-75%) during the initial years (2012-2014); however, it improved significantly during later years (86-100%). Future research should explore reasons for non-compliance so that the quality of patient care can be improved.
Keyphrases
- end stage renal disease
- ejection fraction
- multidrug resistant
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- primary care
- escherichia coli
- cystic fibrosis
- type diabetes
- metabolic syndrome
- mental health
- combination therapy
- adipose tissue
- acinetobacter baumannii
- physical activity
- patient reported
- pulmonary tuberculosis