Multidrug-resistant tuberculosis patients' views of interventions to reduce treatment loss to follow-up.
Patients who initiated treatment for multidrug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012.



To describe patients' views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up.



In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed.



Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants.



A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner.
Tropical Disease Foundation, Inc, Makati City, The Philippines.
T
T
Tupasi
The National Tuberculosis Control Program, Department of Health, Manila, The Philippines.
A M C G
AM
Garfin
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J M
JM
Mangan
Philippine Business for Social Progress-Innovations and Multisectoral Partnership to Achieve Control of Tuberculosis (IMPACT) Project, Manila, The Philippines.
R
R
Orillaza-Chi
Tropical Disease Foundation, Inc, Makati City, The Philippines.
L C
LC
Naval
Tropical Disease Foundation, Inc, Makati City, The Philippines.
G I
GI
Balane
The National Tuberculosis Control Program, Department of Health, Manila, The Philippines.
R
R
Basilio
US Agency for International Development, Washington DC, USA.
A
A
Golubkov
Tropical Disease Foundation, Inc, Makati City, The Philippines.
E S
ES
Joson
World Health Organization Philippines, Manila, The Philippines.
W-J
WJ
Lew
The National Center for Pulmonary Research, Lung Center of the Philippines, Quezon City, The Philippines.
V
V
Lofranco
Department of Health, Manila, The Philippines.
M
M
Mantala
The National Center for Pulmonary Research, Lung Center of the Philippines, Quezon City, The Philippines.
S
S
Pancho
Tropical Disease Foundation, Inc, Makati City, The Philippines.
J N
JN
Sarol
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
A
A
Blumberg
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
D
D
Burt
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
E V
EV
Kurbatova
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010679:Philippines / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents