Patient Choice Promotes Adherence in Preventive Treatment for Latent Tuberculosis

¹ NE London TB Network, Homerton University Hospital, Homerton Row, London, E9 6SR, England
² Dept of Practice and Policy, School of Pharmacy, University of London, London, England

^* To whom correspondence should be addressed. E-mail: timothy.rennie{at}homerton.nhs.uk.

	Abstract

To compare the effect of patient choice on completion rates and adverse drug reactions for patients treated for latent tuberculosis infection (LTBI) using 3-months rifampicin and isoniazid (3RH) or 6-months isoniazid (6H).

Data for all patients treated using 3RH or 6H for LTBI between 1998 and 2004 were analyzed.

675 patients attended for chemoprophylaxis. 314 received 3RH and 277 received 6H. From 1^st April 2000, patients were offered a choice of regimen. 53.5% successfully completed, a further 10.3% potentially completed and 36.2% failed to complete treatment. Logistic regression analysis suggested that successful completion was more likely in patients that were younger (an association lost after removing all those under 16 years), offered a choice of regimen and attended all clinics before commencing treatment. Treatment was discontinued due to adverse reactions in 16 (5.1%) patients prescribed 3RH and 16 (5.8%) prescribed 6H. Treatment failure was most likely for both regimens during the first 4 weeks of treatment. At 13 weeks treatment, more patients taking 6H had stopped compared to those completing the 3RH regimen. Drug costs were greater using 6H compared with 3RH.

Offering a choice of regimen improves completion. Most patients chose 3RH over 6H. Adverse drug reaction rates between the two regimens were similar. Keywords: adherence; adverse effects; choice; isoniazid; latent tuberculosis; rifampicin.

This article has been cited by other articles:

				U. Mack, G. B. Migliori, M. Sester, H. L. Rieder, S. Ehlers, D. Goletti, A. Bossink, K. Magdorf, C. Holscher, B. Kampmann, et al. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement Eur. Respir. J., May 1, 2009; 33(5): 956 - 973. [Abstract] [Full Text] [PDF]

				G. H. Bothamley, L. Ditiu, G. B. Migliori, C. Lange, and TBNET contributors Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey Eur. Respir. J., October 1, 2008; 32(4): 1023 - 1030. [Abstract] [Full Text] [PDF]