Interventions for improving adherence to treatment for latent tuberculosis infection: a systematic review.
Latent tuberculosis infection (LTBI) control relies on high initiation and completion rates of preventive treatment to preclude progression to tuberculosis disease. Specific interventions may improve initiation and completion rates. The objective was to systematically review data on determinants of initiation, adherence and completion of LTBI treatment, and on interventions to improve initiation and completion.



A systematic review of the literature (PubMed, Embase) published up to February 2014 was performed. Relevant prospective intervention studies were assessed using GRADE.



Sixty-two articles reporting on determinants of treatment initiation and completion were included and 23 articles on interventions. Determinants of LTBI treatment completion include shorter treatment regimen and directly observed treatment (DOT, positive association), adverse events and alcohol use (negative association), and specific populations with LTBI (both positive and negative associations). A positive effect on completion was noted in intervention studies that used short regimens and social interventions; mixed results were found for intervention studies that used DOT or incentives.



LTBI treatment completion can be improved by using shorter regimens and social interventions. Specific needs of the different populations with LTBI should be addressed taking into consideration the setting and condition in which the LTBI treatment programme is implemented.
Pallas health research and consultancy BV, Rotterdam, The Netherlands.
Anke L
AL
Stuurman
Pallas health research and consultancy BV, Rotterdam, The Netherlands.
Marije
M
Vonk Noordegraaf-Schouten
Pallas health research and consultancy BV, Rotterdam, The Netherlands.
Femke
F
van Kessel
Pallas health research and consultancy BV, Rotterdam, The Netherlands.
Anouk M
AM
Oordt-Speets
European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11a, Solna, 171 65, Sweden.
Andreas
A
Sandgren
European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11a, Solna, 171 65, Sweden. marieke.vanderwerf@ecdc.europa.eu.
Marieke J
MJ
van der Werf
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D006801:Humans; D055985:Latent Tuberculosis / Q000188:drug therapy* / Q000517:prevention & control; D009042:Motivation; D010349:Patient Compliance; D011446:Prospective Studies
D000995:Antitubercular Agents
Latent tuberculosis; Risk groups; Treatment adherence; Treatment completion; Treatment initiation; Tuberculosis