Evidence map›Paper›PMID 30709351›Full record

ArticleBMC health services research2019

Are they there yet? Linkage of patients with tuberculosis to services for tobacco cessation and alcohol abuse - a mixed methods study from Karnataka, India.

Nagendra Navya, Kathiresan Jeyashree, Akshaya Kibballi Madhukeshwar, Tanu Anand, Abhay Subashrao Nirgude, Badarudeen Mohammad Nayarmoole, Petros Isaakidis

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
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  6. Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key.Journal of clinical tuberculosis and other mycobacterial diseases · 2020
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Nagendra NavyaDepartment of Community Medicine, Yenepoya Medical College, Mangaluru, India. navya1211@yahoo.com.ORCID http://orcid.org/0000-0001-6744-4632
Kathiresan JeyashreeDepartment of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, India.
Akshaya Kibballi MadhukeshwarDepartment of Community Medicine, Yenepoya Medical College, Mangaluru, India.
Tanu AnandDepartment of Community Medicine, North Delhi Municipal Corporation Medical College Hindu Rao Hospital, New Delhi, India.
Abhay Subashrao NirgudeDepartment of Community Medicine, Yenepoya Medical College, Mangaluru, India.
Badarudeen Mohammad NayarmooleDistrict Tuberculosis Office, Mangaluru, Dakshina Kannada, Karnataka, India.
Petros IsaakidisMédecins Sans Frontières, Operational Research Unit, Luxembourg City, Luxembourg.
Yenepoya University · INHindu Rao Hospital · INMédecins Sans Frontières · LUNational Tuberculosis Institute · INVelammal Medical College Hospital and Research Institute · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTobacco use and alcohol abuse are associated with higher risk of tuberculosis (TB) infection, progression to active TB and adverse treatment outcomes among patients with TB. Revised National Tuberculosis Control Programme (RNTCP) treatment guidelines (2016) require the documentation of tobacco and alcohol use among patients with TB and their linkage to tobacco and alcohol abuse treatment services. This study aimed to assess the extent of documentation of tobacco and alcohol usage data in the TB treatment card and to explore in-depth, the operational issues involved in linkage.

methodsA convergent parallel mixed methods study was conducted. All new TB treatment cards of adult patients registered under RNTCP between January and June 2017 in Dakshina Kannada district were reviewed to assess documentation. Document review was done to understand the process of linkage (directing patients to tobacco and alcohol abuse treatment services). In-depth interview of health care providers (n = 7) and patients with TB (n = 5) explored into their perspectives on linkage.

resultsAmong 413 treatment cards reviewed, tobacco use was documented in 322 (78%), of whom 86 (21%) were documented as current tobacco users. Sixteen (19%) out of these 86 patients were linked to tobacco cessation services. Alcohol usage status was documented in 319 (77%) cards of whom 71(17%) were documented as alcohol users. Eleven (16%) out of these 71 patients were linked to alcohol abuse treatment services. The questions in the treatment card lacked clarity. Guidelines on eliciting history of substance abuse and criteria for linkage were not detailed. Perceived enablers for linkage included family support, will power of the patients and fear of complications. Challenges included patient's lack of motivation, financial and time constraints, inadequate guidelines and lack of co-ordination mechanisms between TB programme and tobacco/alcohol abuse treatment services.

conclusionDocumentation was good but not universally done. Clear operational guidelines on linkage and treatment guidelines for health care providers to appropriately manage the patients with comorbidities are lacking. Lack of coordination between the TB treatment programme and tobacco cessation as well as alcohol treatment services was considered a major challenge in effective implementation of the linkage services.

Indexed as

AdultAlcoholismFemaleHealth PersonnelHumansIndiaMaleMiddle AgedRural HealthSubstance-Related DisordersTobacco SmokingTobacco Use CessationTuberculosisUrban HealthAlcoholismIntegrated delivery systemOperational researchSORT ITTobacco useTuberculosis

Identifiers

PMID30709351
PMCPMC6359801
OpenAlexW2924964730

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.