A Medication Adherence Enhancement Program for Persons with Pulmonary Tuberculosis: A Randomized Controlled Trial Study
Keywords:
Medication adherence, Pulmonary tuberculosis, Self-efficacy, Self-regulation, Treatment successAbstract
Successful tuberculosis treatment is strongly dependent on medication adherence throughout the full course of treatment. This randomized controlled trial examined the effects of the Medication Adherence Enhancement Program for persons with pulmonary tuberculosis on treatment success and medication adherence in a hospital in northern Thailand. Fifty participants meeting the inclusion criteria were randomly assigned to either an intervention (n=25) or control (n=25) group. The intervention group received the Program based on the social cognitive theory in addition to usual care, while the control group received only usual care. The Program duration was 8 weeks, and included 7 sessions: 5 for providing knowledge and raising self-efficacy for self-regulation to adhere to medication, and 2 for reminding and counselling. Medication adherence was assessed using the Anti-Tuberculosis Medication Adherence Scale, while treatment success was evaluated by using the Criteria to Identify Tuberculosis Treatment Outcomes of the World Health Organization. Fisher’s exact test and Mann-Whitney U test were used analysed data. Results revealed that the mean score of medication adherence inthe intervention group at 3 months after implementing the program was significantly higher than the control group. However, at 6 months after implementation, the mean score of medication adherence and treatment success of the participants in the intervention group was higher than the control group but not significantly different. Nurses may implement this Program to increase medication adherence in the short-term and improve treatment success in targeted persons.References
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27. Ruppar TM. Medication adherence research: More theory-driven interventions are needed. West J Nurs Res. 2010; 32: 847-848.
28. Sirur R, Richarson J, Wishart L, Hanna S. The role of theory in increasing adherence prescribed practice. Physiother Can. 2009; 61(2): 68-77.
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31. Polit DF, Beck CT. Nursing Research: Principles and Methods (7thed.). Philadelphia: Lippincott Williams & Wilkins; 2004.
32. Chuldeja S. An application of self-efficacy theory to modify compliance behavior among pulmonary tuberculosis patients at the Tuberculosis Regional Center 2, Saraburi province. (Master thesis). Bangkok:Mahidol University; 1997 (in Thai).
33. Boonpendecha L. An application of self-efficacy theory to compliance behaviors modification among pulmonary tuberculosis patients at Pranakhonsriayathaya hospital. (Master thesis). Bangkok:Mahidol University; 2001 (in Thai).
34. The Office of Disease Prevention and Control 9, Phitsanulok Provincial Health Office. The project of promoting access to quality of care, treatment, and disease prevention, and enhancing community empowerment for TB control in Thailand, 3rd year, Phitsanulok Province, fiscal year of 2014. (Project documents). Phitsanulok: The Office of Disease Prevention and Control 9; 2013 (in Thai).
35. Bandura A. Perceived self-efficacy in cognitive development and functioning. Educ Psychol. 1993, 28(2): 117-148.
36. Schunk DH, Ertmer PA. Self-regulation and academic learning self-efficacy enhancing interventions. In Boekaerts M, Pintrich PR, Zeidner M. Handbook of self-regulation. United States: Academic Press; 2000, pp. 631-649.
37. Zimmerman BJ. Attaining self-regulation: A social cognitive perspective. In Boekaerts M, Pintrich PR, Zeidner M. Handbook of self-regulation. United States: Academic Press; 2000, pp. 13-39.
38. Dick J, Lombard C. Shared vision-a health education project designed to enhance adherence to anti-tuberculosis treatment. Int Tuberc Lung Dis. 1997; 1(2): 181-186.
39. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2): 143-164.
40. Podewils LJ, Gler MTS, Quelapio MI, Chen MP. Patterns of treatment interruption among patients with multidrug-resistantTB (MDR TB) and association with interim and final treatment outcomes. PLoS ONE. 2013; 8(7): e70064.
41. Jakubowiak W, Bogorodskaya E, Borisov S, Danilova I, Kourbatova E. Treatment interruptions and duration associated with default among new patients with tuberculosis in six regions of Russia. Int J Infect Dis. 2009; 13: 362-368.
42. Arkaravichien W, Usawamethapun S, Soonthornpas C. A comparative study of tuberculosis patients who can and cannot comply with DOTS. Thai J Tuberc Chest Dis Cri Care.2003; 24: 53-60 (in Thai).
2. National Department of Health. National tuberculosis management guidelines 2014. Pretoria: Department of Health, Republic of South Africa; 2014.
3. WHO. Treatment of tuberculosis guidelines. Geneva:WHO; 2010.
4. Kruk ME, Schwalbe NR, Aguiar CA. Timing of default from tuberculosis treatment: A systematic review. Trop Med and Int Health. 2008; 13(5): 703-712.
5. Menzies D, Long R, Trajman A, Dion MJ, Yang J, Jahdali HA.et al. Adverse events with 4 months of rifampin therapy or 9 months of isoniazid therapy for latent tuberculosis infection. Ann Intern Med. 2008; 149: 689-697.
6. Grzemaka M. Tuberculosis drug therapy in adults. In Schaaf HS, Zumla AI. Tuberculosis: A comprehensive clinical reference. British: Saunders Elsevier; 2009, pp. 638-648.
7.Zvavamwe Z, Ehlers VJ. Experiences of a community-based tuberculosis treatment program in Namibia: A comparative cohort study. Int J Nurs Stu. 2009; 46: 302-9.
8.Bureau of Tuberculosis. National guideline for management of tuberculosis control, 2013. [Cited 2015 Feb 20]. Available from www.thaichestorg/atat3/pdf/guideline/TB.pdf (in Thai).
9. WHO. Global tuberculosis report 2014. Geneva: WHO; 2014.
10. The Global Fund. Round 8 tuberculosis: Strengthening quality TB control among vulnerable populations in Thailand. Geneva: The Global Fund; 2008.
11.Out AA. Is DOTS an effective strategy for TB control in developing country?. Afr J Res Med. 2013; 9(1): 5-6.
12. Phokaew P, Arunkanjana P, Chaiwong N. Does Dot work?: A study in Chiang Mai Center. Thai J Tuberc Chest Dis. 2001; 22: 113-123 (in Thai).
13. Volmink J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database of systematic reviews.2007; 3, Art No: CD003343.
14. M’Imunya JM, Kredo T, Volmink J. Patient education and counseling for promoting adherence to treatment for tuberculosis. Cochrane Database of Systematic Reviews. 2012; 5, Art. No: CD006591.
15. Liu Q, Abba K, Alejandria MM, Sinclair D, Balanag VM, Lansang MAD. Reminder systems to improve patient adherence to tuberculosis clinical appointments for diagnosis and management. Cochrane Database of Systematic Reviews. 2014; 11, Art. No: CD006594.
16. Suwannakeeree W, Picheansathian W. Strategies to promote adherence to treatment by pulmonary tuberculosis patients: A systematic review. Int J Evid Based Health. 2014; 12: 3-16.
17. Haynes RB, Achloo E, Sahota N, McDonald HP, Yao X. Intervention for enhancing medication adherence. Cochrane Database of Systematic Reviews. 2008; 2, Art. No: CD000011.
18. Van Dulmen S, Sluijs E, Van Dijk L, De Ridder D, Heerdink R, Bensing J. Patient adherence to medical treatment: A review of reviews. BMC Health Serv Res. 2007;7(55):1-13.
19. Hsieh CJ, Lin LC, Kuo BIT, Chiang CH, Su WJ, Shih JF. Exploring the efficacy of a management model using DOTs in the adherence of patients with pulmonary tuberculosis. J Clin Nurs.2008; 17: 869-875.
20. Chimbanrai B, Fungladda W, Kaewkungwal J, Silachamroom U. Treatment-seeking behaviors and improvement in adherence to treatment regimen of tuberculosis patients using intensive triad-model program, Thailand. South Asian J Trop Med Public Health. 2008; 39(3): 526-541.
21. Sumano A. Effects of home visit program toward pulmonary tuberculosis patients compliant in Si Racha district, Chon Buri Province. (Master thesis). Chon Buri: Burapha University; 2007 (in Thai).
22. Tansakul S, Luksamijarulkol P, Kerdmongkol P, Sukwongtanon D. The effectiveness of self-regulated learning on compliance with treatment among tuberculosis patients attending at Bangkok Cheat Clinic.Thai J Nurs. 2003; 52(2): 135-43 (in Thai).
23. Bam TS, Gunneberg C, Chamroonsawasdi K, Bam DS, Aalberg O, Kasland O, et al. Factors affecting patient adherence to DOTS in urban Kathmandu, Nepal. Int Tuberc Lung Dis. 2006; 10(3): 270-276.
24. Berben L, Dobbels F, Engberg S, Hill MN, De Geest S. An ecological perspective on medication adherence. West J Nur Res. 2012; 34(5): 635-653.
25. Tipaht P. Factors associated with success of treatment among new smear- positive pulmonary tuberculosis patients in Urban and Rural area in Chaiyaphum Province, Thailand. (Master thesis). KhonKaen: KhonKaen University; 2008(in Thai).
26. Bandura A. Social foundations of thought and action: A social cognitive theory. New Jersey: Prentice-Hall; 1986.
27. Ruppar TM. Medication adherence research: More theory-driven interventions are needed. West J Nurs Res. 2010; 32: 847-848.
28. Sirur R, Richarson J, Wishart L, Hanna S. The role of theory in increasing adherence prescribed practice. Physiother Can. 2009; 61(2): 68-77.
29. Barnason S, Zimmerman L, Hertzog M, & Schulz P. Pilot testing of a medication self-management transition intervention for heart failure patients. Western J Nurs Res. 2010; 32: 849-870.
30. Chen SY, Sheu S, Chang CS, Wang TH, Huang MS. The effects of the self-efficacy method on adult asthmatic patient self-care behavior. J Nurs Res. 2010; 18(4): 266-274.
31. Polit DF, Beck CT. Nursing Research: Principles and Methods (7thed.). Philadelphia: Lippincott Williams & Wilkins; 2004.
32. Chuldeja S. An application of self-efficacy theory to modify compliance behavior among pulmonary tuberculosis patients at the Tuberculosis Regional Center 2, Saraburi province. (Master thesis). Bangkok:Mahidol University; 1997 (in Thai).
33. Boonpendecha L. An application of self-efficacy theory to compliance behaviors modification among pulmonary tuberculosis patients at Pranakhonsriayathaya hospital. (Master thesis). Bangkok:Mahidol University; 2001 (in Thai).
34. The Office of Disease Prevention and Control 9, Phitsanulok Provincial Health Office. The project of promoting access to quality of care, treatment, and disease prevention, and enhancing community empowerment for TB control in Thailand, 3rd year, Phitsanulok Province, fiscal year of 2014. (Project documents). Phitsanulok: The Office of Disease Prevention and Control 9; 2013 (in Thai).
35. Bandura A. Perceived self-efficacy in cognitive development and functioning. Educ Psychol. 1993, 28(2): 117-148.
36. Schunk DH, Ertmer PA. Self-regulation and academic learning self-efficacy enhancing interventions. In Boekaerts M, Pintrich PR, Zeidner M. Handbook of self-regulation. United States: Academic Press; 2000, pp. 631-649.
37. Zimmerman BJ. Attaining self-regulation: A social cognitive perspective. In Boekaerts M, Pintrich PR, Zeidner M. Handbook of self-regulation. United States: Academic Press; 2000, pp. 13-39.
38. Dick J, Lombard C. Shared vision-a health education project designed to enhance adherence to anti-tuberculosis treatment. Int Tuberc Lung Dis. 1997; 1(2): 181-186.
39. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2): 143-164.
40. Podewils LJ, Gler MTS, Quelapio MI, Chen MP. Patterns of treatment interruption among patients with multidrug-resistantTB (MDR TB) and association with interim and final treatment outcomes. PLoS ONE. 2013; 8(7): e70064.
41. Jakubowiak W, Bogorodskaya E, Borisov S, Danilova I, Kourbatova E. Treatment interruptions and duration associated with default among new patients with tuberculosis in six regions of Russia. Int J Infect Dis. 2009; 13: 362-368.
42. Arkaravichien W, Usawamethapun S, Soonthornpas C. A comparative study of tuberculosis patients who can and cannot comply with DOTS. Thai J Tuberc Chest Dis Cri Care.2003; 24: 53-60 (in Thai).
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2015-11-18
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Suwannakeeree W, Picheansathian W, Lertwatthanawilat W, Unahalekhaka A. A Medication Adherence Enhancement Program for Persons with Pulmonary Tuberculosis: A Randomized Controlled Trial Study. PRIJNR [Internet]. 2015 Nov. 18 [cited 2024 Nov. 18];19(4):311-29. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/21104
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