ArticleBMJ open2017
Burden of non-adherence to latent tuberculosis infection drug therapy and the potential cost-effectiveness of adherence interventions in Canada: a simulation study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies.NPJ primary care respiratory medicine · 2020Pooled it
- The implementation of tuberculosis preventive therapy in HIV care clinics in Africa, Asia and Latin America: a multiregional site survey.BMJ global health · 2026Article
- Factors Associated with Non-Adherence to Tuberculosis Preventive Treatment among Adult Contacts of Pulmonary Tuberculosis Cases with Latent Tuberculosis Infection in Catalonia, Spain, in 2019-2021.Tropical medicine and infectious disease · 2024Article
- Estimating medication adherence from Electronic Health Records: comparing methods for mining and processing asthma treatment prescriptions.BMC medical research methodology · 2023Article
- IL-10 Modulation Increases Pyrazinamide's Antimycobacterial Efficacy against Mycobacterium tuberculosis Infection in Mice.ImmunoHorizons · 2023Article
- Inclusion of non-medical interventions in model-based economic evaluations for tuberculosis: A scoping review.PloS one · 2023Article
- What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map.Campbell systematic reviews · 2022Review
- Global reporting on tuberculosis preventive treatment among contacts.The European respiratory journal · 2022Article
- Real-world association of adherence with outcomes and economic burden in patients with tuberculosis from South Korea claims data.Frontiers in pharmacology · 2022Article
- Linkage of primary care prescribing records and pharmacy dispensing Records in the Salford Lung Study: application in asthma.BMC medical research methodology · 2020Article
- Mobile phone short message service for adherence support and care of patients with tuberculosis infection: Evidence and opportunity.Journal of clinical tuberculosis and other mycobacterial diseases · 2019Review
- Evaluating the potential costs and impact of digital health technologies for tuberculosis treatment support.The European respiratory journal · 2018Article
- Monitoring tuberculosis contact tracing outcomes in Western Sydney, Australia.BMJ open respiratory research · 2018Article
- Cost-effectiveness of post-landing latent tuberculosis infection control strategies in new migrants to Canada.PloS one · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI in Canada.
designA microsimulation model of LTBI progression over 25 years.
settingGeneral practice in Canada.
participantsIndividuals with LTBI who are initiating drug therapy.
interventionsA hypothetical intervention with a range of effectiveness was evaluated. Existing drug adherence interventions including peer support, two-way text messaging support, enhanced adherence counselling and adherence incentives were also evaluated. PRIMARY AND SECONDARY OUTCOME MEASURES: Simulation outcomes included healthcare costs, TB incidence, TB deaths and quality-adjusted life years (QALYs). Base case results were interpreted against a willingness-to-pay threshold of $C50 000/QALY.
resultsCompared with current adherence levels, full adherence to LTBI drug therapy could reduce new TB cases from 90.3 cases per 100 000 person-years to 35.9 cases per 100 000 person-years and reduce TB-related deaths from 7.9 deaths per 100 000 person-years to 3.1 deaths per 100 000 person-years. An intervention that increases relative adherence by 40% would bring the population near full adherence to drug therapy and could have a maximum allowable annual cost of approximately $C450 per person to be cost-effective. Based on estimates of effect sizes and costs of existing adherence interventions, we found that they yielded between 900 and 2400 additional QALYs per million people, reduced TB deaths by 5%-25% and were likely to be cost-effective over 25 years.
conclusionFull adherence could reduce the number of future TB cases by nearly 60%, offsetting TB-related costs and health burden. Several existing interventions are could be cost-effective to help achieve this goal.
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