ArticleBMJ open respiratory research2024
Why do patients with DR-TB do not complete their treatment? Findings of a qualitative study from Pakistan.
Article in BMJ open respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Gendered experiences of people living with tuberculosis or leprosy: A global systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Exploring the readiness of Pakistani pharmacists to become independent prescribers: A qualitative study.Exploratory research in clinical and social pharmacy · 2026Article
- Antimicrobial resistance, equity and justice in low- and middle-income countries: an intersectional critical interpretive synthesis.Nature communications · 2025Article
- Barriers to treatment adherence among patients with tuberculosis: a qualitative study of Pakistani nationals and Afghan refugees.BMJ open · 2025Article
- Health system-related barriers and facilitators to tuberculosis preventive treatment: a qualitative case study comparing implementation in the Republic of Moldova and Georgia.BMJ open respiratory research · 2025Article
- Rifampicin-resistant tuberculosis in Fujian Province, Southeast China: a retrospective analysis of drug resistance screening and treatment outcomes, 2019-2024.Frontiers in public health · 2025Observational
- What are the Real-Life Dilemmas and Facilitators of Medication Adherence of Patients with Drug-Resistant Tuberculosis: A Qualitative Exploration of Patient Perspectives.Infection and drug resistance · 2025Article
- Latent Profile Analysis and Influencing Factors of Medication-Related Burden in Multidrug-Resistant Tuberculosis Patients in Chengdu, China.Patient preference and adherence · 2025Article
- Drug-resistant TB in Morobe Province, Papua New Guinea, 2012-2021.Public health action · 2024Article
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4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOne of the major reasons for unsuccessful treatment outcomes among patients with drug-resistant tuberculosis (DR-TB) is the high rate of loss to follow-up (LTFU). However, in Pakistan, no qualitative study has been conducted to explore the perceptions of LTFU patients with regard to DR-TB treatment, the problems they face and the reasons for LTFU in detail.
methodsThis was a qualitative study that involved semistructured, indepth, face-to-face interviews of 39 LTFU patients with DR-TB. All interviews were carried out in Pakistan's national language 'Urdu' using an interview guide in two phases: the first phase was from December 2020 to February 2021 among patients with extensively drug-resistant tuberculosis and the second phase from July 2021 to September 2021 among patients with multidrug-resistant tuberculosis.
resultsThe inductive thematic analysis of audio-recorded interviews generated the following four key themes, which were the major reasons reported by the participants of the current study to have led to LTFU: (1) patient-related factors, such as lack of awareness about the total duration of DR-TB treatment, fatigue from previous multiple failed episodes, lack of belief in treatment efficacy and perception of DR-TB as a non-curable disease; (2) medication-related factors, such as use of injectables, high pill burden, longer duration and adverse events; (3) socioeconomic factors, such as gender discrimination, poor socioeconomic conditions, non-supportive family members, social isolation and unemployment; and (4) service provider-related factors, such as distant treatment centres, non-availability of a qualified person, lack of adequate counselling and poor attitude of healthcare professionals.
conclusionIn the current study, patients' perceptions about DR-TB treatment, socioeconomic condition, medication and service provider-related factors emerged as barriers to the successful completion of DR-TB treatment. Increasing patients' awareness about the duration of DR-TB treatment, interacting sessions with successfully treated patients, availability of rapid drug susceptibility testing facilities at treatment centres, decentralising treatment and using the recently recommended all-oral regimen may further decrease the rate of LTFU.
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