ArticlePloS one2018
"Treatment is of primary importance, and social assistance is secondary": A qualitative study on the organisation of tuberculosis (TB) care and patients' experience of starting and staying on TB treatment in Riga, Latvia.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Manualised package intervention to achieve treatment adherence in people with tuberculosis: the IMPACT pilot cluster-RCT.Health technology assessment (Winchester, England) · 2026Trial
- Effect of smoking on drug-resistant tuberculosis treatment outcomes and potential mechanistic pathways: a multicountry cohort study.BMJ open respiratory research · 2025Observational
- Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.BMJ open respiratory research · 2025Article
- Drug-Resistant Tuberculosis Hotspots in Oliver Reginald Tambo District Municipality, Eastern Cape, South Africa.Infectious disease reports · 2024Article
- Drug-Resistant Tuberculosis in Rural Eastern Cape, South Africa: A Study of Patients' Characteristics in Selected Healthcare Facilities.International journal of environmental research and public health · 2024Article
- Forgiveness Is the Attribute of the Strong: Nonadherence and Regimen Shortening in Drug-sensitive Tuberculosis.American journal of respiratory and critical care medicine · 2023Article
- Social Support, Quality of Care, and Patient Adherence to Tuberculosis Treatment in Peru: The Mediating Role of Nurse Health Education.Patient preference and adherence · 2023Article
- Validation of the Working Alliance Inventory- Short Form for Patient (WAI-S-P) in Peruvian Adults.Patient preference and adherence · 2023Article
- TB management in the European Union/European Economic Area: a multi-centre survey.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2021Article
- Article
- Relational Dynamics of Treatment Behavior Among Individuals with Tuberculosis in High-Income Countries: A Scoping Review.Patient preference and adherence · 2021Article
- All nonadherence is equal but is some more equal than others? Tuberculosis in the digital era.ERJ open research · 2020Review
- Patients' perspectives of tuberculosis treatment challenges and barriers to treatment adherence in Ukraine: a qualitative study.BMJ open · 2020Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVulnerable individuals with tuberculosis (TB) struggle to access and stay on treatment. While patient-related and social barriers to TB treatment adherence are well documented, less is known about how the organisation and delivery of TB care influences adherence behaviour.
aimTo examine the influence of TB service organisation and culture on patients' experience of starting and staying on treatment in Riga, Latvia.
methodsAn intervention package to support adherence to TB treatment amongst vulnerable patients in Riga, Latvia was piloted between August 2016 and March 2017. Qualitative observations (5), interviews with staff (20) and with TB patients (10) were conducted mid-way and at the end of the intervention to understand perceptions, processes, and experiences of TB care.
resultsThe organisation of TB services is strongly influenced by a divide between medical and social aspects of TB care. Communication and care practices are geared towards addressing individual risk factors for non-adherence rather than the structural vulnerabilities that patients experience in accessing care. Support for vulnerable patients is limited because of standardised programmatic approaches, resource constraints and restricted job descriptions for non-medical staff.
conclusionProviding support for vulnerable patients is challenged in this setting by the strict division between medical and social aspects of TB care, and the organisational focus on patient-related rather than systems-related barriers to access and adherence. Potential systems interventions include the introduction of multi-disciplinary approaches and teams in TB care, strengthening patient literacy at the point of treatment initiation, as well as stronger linkages with social care organisations.
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