与转诊接受直接观察治疗和治疗不成功相关的因素。

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES International Journal of Tuberculosis and Lung Disease Pub Date : 2024-05-01 DOI:10.5588/ijtld.23.0396
Y D González Diaz, D Palma, H Vargas-Leguás, T Rodrigo, I Molina-Pinargorte, X Casas, N Forcada, J Santiago, N Altet, J-P Millet
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引用次数: 0

摘要

目的描述西班牙接受直接观察治疗(DOT)者的特征,以及与治疗不成功相关的因素。方法这是一项多中心观察性研究,基于对 2006 年至 2019 年期间从结核病综合研究计划(PII-TB)登记处确诊的 18 岁以上结核病患者的前瞻性随访。研究收集了社会人口学和临床变量。结果共纳入 7883 名患者。DOT 的适应症与无家可归(aOR 5.93,95% CI 3.03-11.59)、不活动状态(aOR 2.55,95% CI 2.02-3.23)、饮酒(aOR 1.94,95% CI 1.51-2.48)、使用肠外药物(aOR 1.77,95% CI 1.06-2.95)和 HIV 诊断(aOR 1.96,95% CI 1.16-3.29)有关。治疗不成功与以下因素有关:HIV 诊断(aPR 2.31,95% CI 1.31-4.08)、临床和放射学进展恶化(临床进展:APR 15.59,95% CI 1.31-4.08):APR15.59,95% CI 8.21-29.60;放射学进展:aPR 12.84,95% CI 6.46-25.52)、需要住院(aPR 1.73,95% CI 1.10-2.73)、耐受性不满意(aPR 2.82,95% CI 1.49-5.29)、难以理解处方治疗(aPR 1.结论:优先考虑易感人群是实施新的《2023-2030 年终结结核病全球计划》的一个关键方面。在这些人群中,应增加直接观察治疗的适应症,以确保患者坚持治疗,并对患者进行随访和取得疗效。
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Factors associated with referrals for directly observed treatment and unsuccessful treatment.

OBJECTIVETo describe the characteristics of people indicated for directly observed treatment (DOT) in Spain, and the factors associated with unsuccessful treatment.METHODSThis was a multicentre observational study based on a prospective follow-up of patients over 18 years old diagnosed with TB between 2006 and 2019 from the registry of the Programa Integrado de Investigación en Tuberculosis (PII-TB). Sociodemographic and clinical variables were collected. Adjusted odds ratios (aORs) were calculated for the indication of DOT and for having an unsuccessful treatment.RESULTSA total of 7,883 patients were included. The indication of DOT was associated with being homeless (aOR 5.93, 95% CI 3.03-11.59), inactivity status (aOR 2.55, 95% CI 2.02-3.23), alcohol consumption (aOR 1.94, 95% CI 1.51-2.48), parenteral drug use (aOR 1.77, 95% CI 1.06-2.95) and HIV diagnosis (aOR 1.96, 95% CI 1.16-3.29). Unsuccessful treatment was associated with having an HIV diagnosis (aPR 2.31, 95% CI 1.31-4.08), having a worse clinical and radiological evolution (clinical progression: APR 15.59, 95% CI 8.21-29.60; radiological progression: aPR 12.84, 95% CI 6.46-25.52), need for hospitalisation (aPR 1.73, 95% CI 1.10-2.73), unsatisfactory tolerability (aPR 2.82, 95% CI 1.49-5.29), the existence of difficulties in understanding the prescribed treatment (aPR 1.92, 95% CI 1.21-3.06), as well as worse treatment satisfaction (aPR 7.27, 95% CI 4.32-12.24).CONCLUSIONThe prioritisation of vulnerable populations is a key aspect to carry out the new Global Plan to End TB 2023-2030. In these groups DOT indication should be increased to ensure adherence and patient follow-up and outcomes..

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来源期刊
CiteScore
4.90
自引率
20.00%
发文量
266
审稿时长
2 months
期刊介绍: The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
期刊最新文献
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