title: Factors contributing to medication noncompliance of newly diagnosed smear-positive pulmonary tuberculosis patients in the district of Colombo, Sri Lanka.
abstract: Medication noncompliance hinders effective tuberculosis control. This descriptive study investigates the factors contributing to medication noncompliance among new patients with smear-positive pulmonary tuberculosis on treatment at government health institutions in Colombo, Sri Lanka. In a cohort of patients aged > or =15 years (n = 326), 23% were found to be noncompliers (n = 74) on follow-up. The median age of noncompliers (50 years) was significantly higher than the compliers (45 years). In multivariate logistic regression analysis, factors associated with noncompliance are as follows: being a male, living alone or with extended family, experiencing side effects to medication, perceiving nonsusceptibility to adverse effects of illness, and perceiving no benefit in regular treatment. The participants of a focus group discussion on service factors opined that the reception at treatment facilities and the interaction with certain categories of staff were poor. Noncompliance is related to a multiplicity of factors involving patients and healthcare services.
authors.affiliation: Department of Community Medicine and Epidemiology, Faculty of Medicine, University of Ottawa, Canada. navajanakan@yahoo.com
authors.forename: Navaratnasingam
authors.initials: N
authors.lastname: Janakan
authors.forename: Rdea
authors.initials: R
authors.lastname: Seneviratne
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013188:Sri Lanka; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents