A Mixed-Method Study of Medication-Related Burden Among Multi-Drug Resistant Tuberculosis Patients in West Java, Indonesia.

IF 2.1 Q3 HEALTH CARE SCIENCES & SERVICES ClinicoEconomics and Outcomes Research Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI:10.2147/CEOR.S473768
Yudisia Ausi, Vycke Yunivita, Prayudi Santoso, Deni Kurniadi Sunjaya, Melisa Intan Barliana, Rovina Ruslami
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Abstract

Background: Multidrug-resistant tuberculosis presents a challenging obstacle in global TB control. It necessitates complex and long-term therapy, which can potentially lead to medication-related burdens that may ultimately reduce therapy adherence and quality of life.

Purpose: This study aimed to gain a deep understanding of the medication-related burdens experienced by multidrug-resistant tuberculosis patients.

Methods: The study was conducted using a convergent mixed-method approach involving MDR-TB patients and their caregivers. Qualitative data were collected through semi-structured in-depth interviews, while quantitative data were gathered using the validated Living with Medicine Questionnaire 3. In the quantitative part, associations between patients' characteristics and burden levels were analysed using bivariate and multivariate analyses.

Results: Seventy-four participants were involved in the study, with 71 of them completing the questionnaire and 36 participating in interviews. The qualitative results revealed the subjectivity of medication-related burden perception, which could not be fully captured by the quantitative method. Four themes of medication-related burdens emerged: personal beliefs, regimen burdens, socioeconomic burdens, and healthcare burdens. The quantitative results provided a generalized representation of the population. Age and side effects were found to be significantly associated with higher burden levels, with those aged 18-30 having an odds ratio (OR) of 7.303 (95% CI: 1.045-51.034), and those aged 31-40 having an OR of 6.53 (95% CI: 1.077-39.607). Additionally, experiencing side effects had a substantial impact, with an OR of 46.602 (95% CI: 2.825-768.894). Both sets of results are valuable for designing patient-centered care.

Conclusion: MDR-TB therapy imposes a significant burden, particularly regarding the characteristics of regimen. By understanding this burden, healthcare professionals can help improve the quality of life for these patients.

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印度尼西亚西爪哇耐多药结核病患者用药相关负担的混合方法研究。
背景:耐多药结核病是全球结核病防治工作中的一个挑战性障碍。目的:本研究旨在深入了解耐多药肺结核患者所承受的药物相关负担:研究采用聚合混合方法,由耐多药肺结核患者及其护理人员参与。定性数据通过半结构式深度访谈收集,定量数据则使用经过验证的 "带药生活问卷 3 "收集。在定量分析中,使用双变量和多变量分析法分析了患者特征与负担水平之间的关联:74名参与者参与了研究,其中71人填写了问卷,36人参与了访谈。定性结果显示了用药相关负担认知的主观性,而定量方法无法完全反映这一点。与用药相关的负担出现了四个主题:个人信念、疗程负担、社会经济负担和医疗负担。定量结果提供了人群的普遍代表性。研究发现,年龄和副作用与较高的负担水平显著相关,18-30 岁人群的几率比(OR)为 7.303(95% CI:1.045-51.034),31-40 岁人群的几率比(OR)为 6.53(95% CI:1.077-39.607)。此外,副作用也有很大影响,OR 值为 46.602(95% CI:2.825-768.894)。这两组结果对于设计以患者为中心的护理都很有价值:结论:MDR-TB 治疗带来了巨大的负担,尤其是在治疗方案的特点方面。通过了解这一负担,医护人员可以帮助改善这些患者的生活质量。
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来源期刊
ClinicoEconomics and Outcomes Research
ClinicoEconomics and Outcomes Research HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.70
自引率
0.00%
发文量
83
审稿时长
16 weeks
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