Factors associated with treatment adherence in a randomised trial of latent tuberculosis infection treatment.
METHODS
Randomised controlled trial of latent tuberculosis infection (LTBI) treatment in 10 clinics in Canada, Saudi Arabia and Brazil.


OBJECTIVE
To identify early predictors of LTBI treatment adherence, including pre-treatment characteristics.


METHODS
Patients randomised to 4 months of rifampicin (RMP; n = 420) or 9 months of isoniazid (n = 427) were monitored for adherence using an electronic device. Outcomes were 1) treatment completion, defined as intake of >or=80% of the prescribed doses, and further categorised as completed within the allotted time or not; and 2) treatment regularity, measured by the time interval between doses. Relative risk (RR) and adjusted odds ratios (aOR) of patients' pre-treatment characteristics and adherence at first follow-up visit were calculated.


RESULTS
Completion of treatment was higher with RMP (aOR 4.3, 95%CI 2.7-6.8). Early predictors (first follow-up visit) of non-adherence were late first visit attendance (RR for completion in time 0.9, 95%CI 0.8-0.98), >20% of missed doses (RR 0.4, 95%CI 0.3-0.6) and greater variation of hours between doses (0.209 vs. 0.131, P < 0.001). Serious adverse events were not associated with irregularity of treatment.


CONCLUSIONS
The shorter RMP regimen was associated with better adherence. Patients with poor adherence could be identified at the first follow-up visit from their punctuality in follow-up, missed doses and variability of pill-taking.
Trajman
A
A
Pró-Reitoria de Saúde, Gama Filho University, Brazil. atrajman@gmail.com
Long
R
R
Zylberberg
D
D
Dion
M J
MJ
Al-Otaibi
B
B
Menzies
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012306:Risk; D012529:Saudi Arabia / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin