Can a peer-based intervention impact adherence to the treatment of latent tuberculous infection?
OBJECTIVE
To assess the effectiveness of a peer-based intervention on adherence to and completion of latent tuberculous infection (LTBI) treatment.


METHODS
Patients prescribed self-administered LTBI treatment were enrolled in a randomized controlled trial of an experimental, peer-based adherence support intervention. Primary outcomes were treatment adherence and completion. Adherence was assessed through self-report, electronic monitoring devices and clinic visits.


RESULTS
Of 250 participants, 70% were male; 71% were Black and 20% Latino; the mean age was 40 years; 67% were foreign-born and 39% were married. No significant baseline differences were noted between the intervention groups. Treatment completion was 61% in the intervention group compared to 57% in the controls (P = 0.482). The corresponding completion rate for other clinic patients was 44%. Foreign birth, marriage and history of mental illness were associated with non-completion of treatment after controlling for the intervention group; increased completion rates were found among foreign-born married persons and older participants. A substantial difference in adherence rates was observed between the intervention groups. Adherence among non-completers decreased early, while adherence among completers remained constant.


CONCLUSIONS
The peer-based intervention was not significantly associated with LTBI treatment completion, but was associated with greater adherence. Findings suggest the importance of interventions to support adherence that target early non-adherence with LTBI treatment, particularly in the first 2 months, when there is a substantial risk of default.
ICAP, Columbia University, New York, New York, USA. yh154@columbia.edu
Y
Y
Hirsch-Moverman
P W
PW
Colson
J
J
Bethel
J
J
Franks
W M
WM
El-Sadr
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D055118:Medication Adherence; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D010379:Peer Group; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000995:Antitubercular Agents