title: 'Sputnik': a programmatic approach to improve tuberculosis treatment adherence and outcome among defaulters.
abstract: METHODS
  A novel patient-centered tuberculosis (TB) treatment delivery program, 'Sputnik', was introduced for patients at high risk of treatment default in Tomsk City, Russian Federation.
  
  
  OBJECTIVE
  To assess the effects of the Sputnik intervention on patient default rates.
  
  
  METHODS
  We analyzed the characteristics of patients referred to the program, treatment adherence of Sputnik program enrollees before and during the intervention, and final outcomes for all patients referred to the Sputnik program.
  
  
  RESULTS
  For patients continuing their existing regimens after referral to the program (n = 46), mean adherence to treatment increased by 56% (from 52% of prescribed doses prior to enrolment to 81%). For patients initiating new regimens after referral ( n = 5), mean adherence was 83%. Mean adherence for patients with multidrug-resistant TB (MDR-TB; n = 38) was 79% and for all others (n = 13) it was 89%. The cure rate was 71.1% for patients with MDR-TB, 60% for all others and 68% in the program overall.
  
  
  CONCLUSIONS
  The Sputnik intervention was successful in reducing rates of treatment default among patients at high risk for non-adherence.
authors.affiliation: Partners In Health, Boston, Massachusetts, USA.
authors.forename: I Y
authors.initials: IY
authors.lastname: Gelmanova
authors.forename: D V
authors.initials: DV
authors.lastname: Taran
authors.forename: S P
authors.initials: SP
authors.lastname: Mishustin
authors.forename: A A
authors.initials: AA
authors.lastname: Golubkov
authors.forename: A V
authors.initials: AV
authors.lastname: Solovyova
authors.forename: S
authors.initials: S
authors.lastname: Keshavjee
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009937:Organizational Objectives; D018802:Patient-Centered Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation; D012426:Russia; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy*; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy; D019037:Urban Health Services / Q000458:organization & administration*
chemical_list: D000995:Antitubercular Agents