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v2.1.4829.produseast1

Journal Article > Research

Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care

Harrison RE, Shyleika V, Vishneuski R, Leonovich O, Vetushko D, Skrahina A, Mar HT, Garsevanidze E, Falkenstein C, Sayakci Ö, Martin AIC, Tan C, Sitali N, Viney K, Lonnroth K, Stringer B, Ariti C, Sinha A
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Abstract

BACKGROUND

TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use.


METHODS

An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019–November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted.


RESULTS

There were 89 participants enrolled in the intervention, with a median follow-up of 12.2 (IQR: 8.1–20.5) mo. The majority (n=80; 89.9%) of participants had AUD, 11 (12.4%) also had a dependence on other substances, six (6.7%) a dependence on opioids and three (3.4%) a personality disorder. Fifty-eight had a history of past incarceration (65.2%), homelessness (n=9; 10.1%) or unemployment (n=55; 61.8%). Median adherence was 95.4% (IQR: 90.4–99.6%) and outpatient adherence was 91.2% (IQR: 65.1–97.0%). Lower adherence was associated with hepatitis C, alcohol plus other substance use and outpatient facility-based treatment, rather than video-observed treatment, home-based or inpatient treatment support.


CONCLUSIONS

This intervention led to good adherence to MDR/RR-TB treatment in people with harmful use of alcohol, a group usually at risk of poor outcomes. Poor outcomes were associated with hepatitis C, other substance misuse and outpatient facility-based treatment support.

Countries
Belarus
Subject Area
tuberculosissubstance use disorders
DOI
10.1093/inthealth/ihae066
Published Date
06-Nov-2024
PubMed ID
39501994
Languages
English
Journal
Oxford Medical Journal
Volume / Issue / Pages
Volume Online ahead of print
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