Re-inventing Adherence: Toward a Patient-centered Model of Care for Drug-resistant Tuberculosis and HIV

Overview

Journal Int J Tuberc Lung Dis

Specialty Pulmonary Medicine

Date 2016 Mar 13

PMID 26970149

Citations 40

Authors

M R ODonnell

A Daftary

M Frick

Y Hirsch-Moverman

K R Amico

M Senthilingam

A Wolf

J Z Metcalfe

P Isaakidis

J L Davis

J R Zelnick

J C M Brust

N Naidu

M Garretson

D R Bangsberg

N Padayatchi

G Friedland

Affiliations

Soon will be listed here.

Abstract

Background: Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care.

Objective: To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support.

Discussion: Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully implementing team-based patient-centered care, empowering patients through counseling and support, maintaining a rights-based approach while acknowledging the responsibility of health care systems in providing comprehensive care, and prioritizing critical research gaps.

Conclusion: It is time to re-invent our understanding of adherence in drug-resistant TB and HIV by focusing attention on the complex clinical, behavioral, social, and structural needs of affected patients and communities.

Citing Articles

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