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Early counseling key to boost compliance with LTBI treatment
Early counseling of patients about the importance of completing tuberculosis therapy plays a key role in completion of therapy, according to study data published online.
Kevin B. Spicer, MD, PhD, MPH, of Nationwide Children’s Hospital, and colleagues reported data on 1,516 children aged 19 years and younger who were referred for evaluation and treatment of latent tuberculosis infection (LTBI) and upon discharge were seen in either the main hospital or neighborhood clinics.
Kevin B. Spicer
The researchers reported that about 78% of the children initiated medical therapy and returned for at least one visit.
Children in the clinics were slightly more likely to complete their treatment, but the researchers wrote that “neighborhood and main hospital clinic children did not differ in rates of completion when propensity score-matched groups were compared.” Rather, Spicer and colleagues said the country of origin was important in determining initiation and completion of therapy.
“Treatment of LTBI is complicated by lack of observable signs/symptoms of illness, prolonged duration of therapy, and some difficulty with acceptance of the diagnosis among some groups of patients. Origin of birth (ie, geographic background) was found to be the best predictor of both initiation and completion of treatment of LTBI,” Spicer told Infectious Diseases in Children. “Additionally, we found that a consistent clinic environment, with interpreters and incentives for attendance, was conducive to completion of therapy. Patients who do not follow through with therapy generally drop out early in the process so that an emphasis on patient/family education and early non-clinic (eg, telephone, text) contact may be beneficial in enhancing rates of therapy completion.”
The researchers said their findings point to the need for shorter courses of treatment to improve compliance rates, as well as highlight the potential importance of early counseling and follow-up to boost compliance.
“The referring pediatrician, or the patient’s primary medical provider, can also be influential in the process of education and encouragement as the patient and family’s primary health resource,” Spicer said.
Kevin B. Spicer, MD, PhD, MPH, can be reached at the Section of Infectious Diseases, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205; email: kevin.spicer@nationwidechildrens.org.
Disclosure: Spicer reports no relevant financial disclosures.
