Adherence is associated with the quality of professional-patient interaction in Directly Observed Treatment Short-course, DOTS.
OBJECTIVE
To investigate the association between the behaviour of health professionals as reported by patients, the quality of communication, patients' communication about their disease, and non-adherence to Directly Observed Tuberculosis Treatment Short-course, DOTS.


METHODS
This study was designed as a case-control study based on 50 cases (non-adherents) and 100 controls (adherents), conducted in a hilly western district in Nepal. The participation rate was 80% for 50 cases and 95% for 100 controls. All covariates with p-value<or=0.2 were included in a multivariate logistic regression model to identify the factors significantly associated with treatment non-adherence.


RESULTS
The analysis identified that poor-grade communication (OR=11.2; CI 2.5-50.4) and fair-grade communication (OR=2.7; CI 1.2-6.3) between patients and dispensers were significantly associated with non-adherence.


CONCLUSIONS
Better communication between health professionals, particularly dispensers, and patients is essential for improving treatment adherence in TB treatment, even under DOTS.


CONCLUSIONS
Drug dispensers should be trained to develop their communication skills about the use of medications, associated side effects, benefits and risk of non-adherence, as well as to respect the individual patient's autonomy and integrity.
Mishra
Pranaya
P
The Danish University of Pharmaceutical Sciences, Universitetsparken 2, DK-2100 Copenhagen, Denmark. mishrapranay@hotmail.com
Hansen
Ebba Holme
EH
Sabroe
Svend
S
Kafle
Kumud Kumar
KK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D023801:Directly Observed Therapy / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000592:standards; D011369:Professional-Patient Relations; D011582:Psychological Theory; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology
D000995:Antitubercular Agents