Abstract:

Objective: To analyze the full course use of anti-tuberculosis fixed-dose combination (FDC) in designated tuberculosis hospitals in China and its influencing factors, so as to provide basis for standardized use of FDC. Methods: According to the typical sampling methods, we selected 5 provinces in the east, middle and west of China, one provincial and one prefecture designated tuberculosis hospital were determined in each province. Using a prospective survey method, patients diagnosed and registered with pulmonary tuberculosis from April to July 2021 who received FDC treatment were selected as the study subjects to analyze the full course use and influencing factors of FDC. Results: Among the 2559 registered patients treated with FDC, 1988 patients underwent full course treatment, accounting for 77.69% (1988/2559), while 571 patients stopped using FDC midway, accounting for 22.31% (571/2559), and most of them occurred during the intensive treatment period, accounting for 69.00% (394/571). The results of multivariate Cox regression analysis showed that general hospitals (HR=2.595, 95%CI: 1.753-3.843), provincial hospitals (HR=4.813, 95%CI: 3.347-6.923), patients aged ≥60 years old (HR=1.573, 95%CI: 1.245-1.988), unknown drug resistance status (HR=1.408, 95%CI: 1.189-1.667), and adverse reactions (HR=15.934, 95%CI: 13.248-19.165) were risk factors for discontinuation of FDC. Conclusion: Targeted FDC standardized diagnosis and treatment training should be provided to doctors in general hospitals and provincial hospitals. For patients seeking treatment at the aforementioned hospitals, especially elderly patients, health education and medication guidance should be carried out to strengthen the management during the intensive treatment period to improve the full course usage rate of FDC.

Key words: Tuberculosis, pulmonary, Fixed-dose combination, Factor analysis, statistical