ArticlePloS one2022
Adherence trajectory as an on-treatment risk indicator among drug-resistant TB patients in the Philippines.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Hidden in Success: Gendered Patterns of Suboptimal Care Engagement Among Tuberculosis Patients Who "Successfully" Completed Treatment in South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Early adherence predicts treatment outcomes and mortality in people living with HIV and multidrug-resistant tuberculosis.Annals of epidemiology · 2026Article
- Drug-Resistant Tuberculous Spondylitis Treated with Bedaquiline-Containing Regimens in South Korea: Two Case Reports.Antibiotics (Basel, Switzerland) · 2026Article
- Socio-ecological vulnerability subgroups predict adherence and treatment outcomes in multidrug-resistant tuberculosis and HIV: a latent class analysis.BMC infectious diseases · 2026Article
- Characterizing Treatment Adherence Trajectories in the endTB Multisite Cohort of Drug-Resistant Tuberculosis Patients: An Application of Group-Based Trajectory Modeling.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Hidden in Success: Gendered Patterns of Suboptimal Care Engagement Among TB Patients Who "Successfully" Completed Treatment in South Africa.medRxiv : the preprint server for health sciences · 2025Article
- Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.BMJ open respiratory research · 2025Article
- Integrating narrative and bibliometric approaches to examine factors and impacts of tuberculosis treatment non-compliance.Multidisciplinary respiratory medicine · 2025Article
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11 authors.
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Abstract
introductionHigh levels of treatment adherence are critical for achieving optimal treatment outcomes among patients with tuberculosis (TB), especially for drug-resistant TB (DR TB). Current tools for identifying high-risk non-adherence are insufficient. Here, we apply trajectory analysis to characterize adherence behavior early in DR TB treatment and assess whether these patterns predict treatment outcomes.
methodsWe conducted a retrospective analysis of Philippines DR TB patients treated between 2013 and 2016. To identify unique patterns of adherence, we performed group-based trajectory modelling on adherence to the first 12 weeks of treatment. We estimated the association of adherence trajectory group with six-month and final treatment outcomes using univariable and multivariable logistic regression. We also estimated and compared the predictive accuracy of adherence trajectory group and a binary adherence threshold for treatment outcomes.
resultsOf 596 patients, 302 (50.7%) had multidrug resistant TB, 11 (1.8%) extremely drug-resistant (XDR) TB, and 283 (47.5%) pre-XDR TB. We identified three distinct adherence trajectories during the first 12 weeks of treatment: a high adherence group (n = 483), a moderate adherence group (n = 93) and a low adherence group (n = 20). Similar patterns were identified at 4 and 8 weeks. Being in the 12-week moderate or low adherence group was associated with unfavorable six-month (adjusted OR [aOR] 3.42, 95% CI 1.90-6.12) and final (aOR 2.71, 95% 1.73-4.30) treatment outcomes. Adherence trajectory group performed similarly to a binary threshold classification for the prediction of final treatment outcomes (65.9% vs. 65.4% correctly classified), but was more accurate for prediction of six-month treatment outcomes (79.4% vs. 60.0% correctly classified).
conclusionsAdherence patterns are strongly predictive of DR TB treatment outcomes. Trajectory-based analyses represent an exciting avenue of research into TB patient adherence behavior seeking to inform interventions which rapidly identify and support patients with high-risk adherence patterns.
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