https://doi.org/10.4081/monaldi.2025.3262

Assessing the key factors contributing to non-adherence to pulmonary tuberculosis treatment: a descriptive study

Early Access
Submitted: November 15, 2024
Accepted: December 11, 2024
Published: February 7, 2025
Non-adherence, pulmonary tuberculosis, contributing factors
Abstract Views: 570
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Authors

Mariam Lakara
Department of Nursing, CHARUSAT Campus, Charotar University of Science and Technology, Changa, Gujarat, India.
Anil Kumar Patidar
anilpatidar.nur@charusat.ac.in
https://orcid.org/0000-0003-1474-6041
Department of Nursing, CHARUSAT Campus, Charotar University of Science and Technology, Changa, Gujarat, India.
Anil Sharma
https://orcid.org/0000-0002-1727-5508
Department of Nursing, CHARUSAT Campus, Charotar University of Science and Technology, Changa, Gujarat, India.

Tuberculosis (TB) remains a significant public health challenge, particularly in developing nations like India, where it imposes a considerable burden. This descriptive cross-sectional study aimed to assess the factors affecting noncompliance with TB medications among pulmonary TB patients in an Indian community. A total of 215 participants were selected through non-probability purposive sampling. Data on factors contributing to non-adherence were collected using a structured self-administered questionnaire. Demographic characteristics, including age, gender, education, marital status, occupation, habitat, income, diagnosis, and duration since diagnosis, were recorded and analyzed. Key factors contributing to non-adherence were categorized into personal, economic, social, psychological, health facility, and technological factors. The results demonstrated that the non-adherence rate was 48.3%, while 51.7% of participants exhibited adherence to TB treatment. Discontinuing medication to feel better significantly increased noncompliance risk, especially for those who stopped "most of the time" vs. those who never stopped (odds ratio = 8.693, 95% confidence interval: 3.179-23.77). This study reveals that non-adherence to pulmonary TB treatment is influenced by a range of factors, including personal, economic, social, psychological, health facility, and technological factors, highlighting the need for multifaceted interventions to improve adherence.

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Scopus
Google Scholar
Europe PMC
Dhamnetiya D, Patel P, Jha RP, et al. Trends in incidence and mortality of tuberculosis in India over past three decades: a join point and age-period-cohort analysis. BMC Pulm Med 2021;21:375. DOI: https://doi.org/10.1186/s12890-021-01740-y
WHO. Tuberculosis. 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=In%202023%2C%20an%20estimated%2010.8,TB%20is%20curable%20and%20preventable.
Coleman M, Martinez L, Theron G, et al. Mycobacterium tuberculosis transmission in high-incidence settings—new paradigms and insights. Pathogens 2022;11:1228. DOI: https://doi.org/10.3390/pathogens11111228
Aleckyte A, Dissanayake O, Mpagama S, et al. Reducing the risk of tuberculosis transmission for HCWs in high incidence settings. Antimicrob Resist Infect Control 2021;10:106. DOI: https://doi.org/10.1186/s13756-021-00975-y
Grace AG, Mittal A, Jain S, et al. Shortened treatment regimens versus the standard regimen for drug-sensitive pulmonary tuberculosis. Cochrane Database Syst Rev 2019;12:CD012918. DOI: https://doi.org/10.1002/14651858.CD012918.pub2
Lemma Tirore L, Ersido T, Beyene Handiso T, Shiferaw Areba A. Non-adherence to anti-tuberculosis treatment and associated factors among TB patients in public health facilities of Hossana town, Southern Ethiopia, 2022. Front Med 2024;11:1360351. DOI: https://doi.org/10.3389/fmed.2024.1360351
Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J 2011;26:155-9. DOI: https://doi.org/10.5001/omj.2011.38
Gaur R, Sharma SK, Kumar S, et al. Knowledge, attitude and perceived barriers related to directly observed treatment, short-course among patients and caregivers attending tuberculosis clinics: a cross-sectional survey. Monaldi Arch Chest Dis 2024. doi: 10.4081/monaldi.2024.3154. DOI: https://doi.org/10.4081/monaldi.2024.3154
Mir TH. Adherence versus compliance. HCA Healthc J Med 2023;4:219-20. DOI: https://doi.org/10.36518/2689-0216.1513
Vishwakarma D, Gaidhane A, Sahu S, Rathod AS. Multi-drug resistance tuberculosis (MDR-TB) challenges in India: a review. Cureus 2023;15:e50222. DOI: https://doi.org/10.7759/cureus.50222
WHO. Drug-resistant TB. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023/tb-disease-burden/1-3-drug-resistant-tb.
WHO. Tuberculosis: multidrug-resistant (MDR-TB) or rifampicin-resistant TB (RR-TB). Available from: https://www.who.int/news-room/questions-and-answers/item/tuberculosis-multidrug-resistant-tuberculosis-(mdr-tb).
Jeyashree K, Thangaraj JWV, Shanmugasundaram D, et al. Ni-kshay poshan yojana: receipt and utilization among persons with TB notified under the National TB Elimination Program in India, 2022. Glob Health Action 2024;17:2363300. DOI: https://doi.org/10.1080/16549716.2024.2363300
Thakur G, Thakur S, Thakur H. Status and challenges for tuberculosis control in India -Stakeholders' perspective. Indian J Tuberc 2021;68:334-9. DOI: https://doi.org/10.1016/j.ijtb.2020.10.001
Das R, Baidya S, Das JC, Kumar S. A study of adherence to DOTS regimen among pulmonary tuberculosis patients in West Tripura District. Indian J Tuberc 2015;62:74-9. DOI: https://doi.org/10.1016/j.ijtb.2015.04.005
Thamineni R, Peraman R, Chenniah J, et al. Level of adherence to anti‐tubercular treatment among drug‐sensitive tuberculosis patients on a newly introduced daily dose regimen in south India: a cross‐sectional study. Trop Med Int Health 2022;27:1013-23. DOI: https://doi.org/10.1111/tmi.13824
Subbaraman R, Thomas BE, Kumar JV, et al. Understanding nonadherence to tuberculosis medications in India using urine drug metabolite testing: a cohort study. In Open Forum Infect Dis 2021;8:ofab190. DOI: https://doi.org/10.1093/ofid/ofab190
Pore PD, Kumar A, Farooqui IA. Noncompliance to directly observed treatment short course in Mulshi block, Pune district. Indian J Community Med 2020;45:291-4. DOI: https://doi.org/10.4103/ijcm.IJCM_137_19
Shinde AM. Socio-demographic factors & adherence of newly diagnosed pulmonary tuberculosis patients to the newly introduced daily regimen: a hospital survey based follow up study. Indian J Tuberc 2024;71:S250-7. DOI: https://doi.org/10.1016/j.ijtb.2024.03.011
Bagchi S, Ambe G, Sathiakumar N. Determinants of poor adherence to anti-tuberculosis treatment in Mumbai, India. Int J Prev Med 2010;1:223-32.
Motappa R, Fathima T, Kotian H. Appraisal on patient compliance and factors influencing the daily regimen of anti-tubercular drugs in Mangalore city: a cross-sectional study. F1000Res 2022;11:462. DOI: https://doi.org/10.12688/f1000research.109006.1
Kaona FA, Tuba M, Siziya S, Sikaona L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health 2004;4:68. DOI: https://doi.org/10.1186/1471-2458-4-68
Kumar L, Kumar S, Vohra V, et al. Risk factors of treatment interruptions among drug-sensitive and drug-resistant pulmonary tuberculosis patients - a study from South Delhi, New Delhi, India. Indian J Tuberc 2024;71:S72-6. DOI: https://doi.org/10.1016/j.ijtb.2024.01.001
Gupta S, Behera D. Reasons for interruption of anti-tubercular treatment as reported by patients with tuberculosis admitted in a tertiary care institute. Indian J Tuberc 2011;58:11-7.

Ethics Approval

The study protocol was approved by the institutional Ethics Committee of the Charotar University of Science and Technology protocol no. IEC/CHARUSAT/23/143.

How to Cite

Lakara, Mariam, Anil Kumar Patidar, and Anil Sharma. 2025. “Assessing the Key Factors Contributing to Non-Adherence to Pulmonary Tuberculosis Treatment: A Descriptive Study”. Monaldi Archives for Chest Disease, February. https://doi.org/10.4081/monaldi.2025.3262.
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