Research progress on medication adherence in patients with pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20250173

Abstract

Abstract:

Tuberculosis is one of the global public health issues. Strengthening the management of pulmonary tuberculosis(PTB) patients and improving their medication adherence is crucial to increasing PTB cure rate, controlling PTB spread, and reducing socio-economic burden, and it is also the main way to realize the strategic goal of ending TB. This paper summarizes current situation of PTB patients’ medication adherence and its influencing factors and interventions, aiming to provide theoretical basis and practical guidance for improving medication adherence in PTB patients.

Key words: Tuberculosis,pulmonary, Self administration, Review literature as topic

CLC Number:

Wang Huijuan, Cheng Ruixia, Xu jia. Research progress on medication adherence in patients with pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1212-1219. doi: 10.19982/j.issn.1000-6621.20250173

References 88

[1]	World Health Organization. Global tuberculosis report 2024. Geneva: World Health Organization, 2024.
[2]	何裕畅, 叶志辉, 张秀莲, 等. 老年肺结核患者治疗的研究进展. 中国防痨杂志, 2025, 47(S1):361-363.
[3]	Pradipta IS, Houtsma D, van Boven JFM, et al. Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies. NPJ Prim Care Respir Med, 2020, 30(1):21. doi:10.1038/s41533-020-0179-x.
[4]	Imperial MZ, Nahid P, Phillips PPJ, et al. A patient-level pooled analysis of treatment-shortening regimens for drug-susceptible pulmonary tuberculosis. Nat Med, 2018, 24(11):1708-1715. doi:10.1038/s41591-018-0224-2. pmid: 30397355
[5]	World Health Organization. Handbook for the use of digital technologies to support tuberculosis medication adherence. Geneva: World Health Organization, 2017.
[6]	中国防痨协会. 耐药结核病化学治疗指南(2015). 中国防痨杂志, 2015, 37(5):421-469. doi:10.3969/j.issn.1000-6621.2015.05.001.
[7]	Chakaya J, Petersen E, Nantanda R, et al. The WHO Global Tuberculosis 2021 Report-not so good news and turning the tide back to End TB. Int J Infect Dis, 2022, 124 Suppl 1:S26-S29. doi:10.1016/j.ijid.2022.03.011.
[8]	殷晓旭. 结核病患者遵医行为影响因素研究及评定量表研制. 武汉:华中科技大学, 2013. doi:10.7666/d.D409600.
[9]	李思琴, 黄姝绮, 吴晓妍, 等. 脑卒中合并高血压病人降压药物服药依从性研究进展. 护理研究, 2021, 35(3): 442-445. doi:10.12102/j.issn.1009-6493.2021.03.014.
[10]	吴韬, 钱瑞莲, 方媛媛. 计划行为理论在服药依从性中应用的研究进展. 护理研究, 2022, 36(6): 1042-1047. doi:10.12102/j.issn.1009-6493.2022.06.018.
[11]	Chimeh RA, Gafar F, Pradipta IS, et al. Clinical and economic impact of medication non-adherence in drug-susceptible tuberculosis: a systematic review. Int J Tuberc Lung Dis, 2020, 24(8):811-819. doi:10.5588/ijtld.19.0754. pmid: 32912386
[12]	Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care, 1986, 24(1):67-74. doi:10.1097/00005650-198601000-00007. pmid: 3945130
[13]	侯凯旋, 闫素英. 慢病患者药物依从性量表的研究. 中国医院药学杂志, 2018, 38(2):192-196. doi:10.13286/j.cnki.chinhosppharmacyj.2018.02.18.
[14]	Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich), 2008, 10(5):348-354. doi:10.1111/j.1751-7176.2008.07572.x.
[15]	王洁, 莫永珍, 卞茸文. 中文版8条目Morisky用药依从性问卷在2型糖尿病患者中应用的信效度评价. 中国糖尿病杂志, 2013, 21(12):1101-1104. doi:10.3969/j.issn.1006-6187.2013.12.013.
[16]	许卫华, 王奇, 梁伟雄. 慢性疾病患者服药依从性测量量表的编制. 中国慢性病预防与控制, 2008, 16(6):558-560,567. doi:10.3969/j.issn.1004-6194.2008.06.003.
[17]	高旭东, 张平, 孔婵, 等. 肺结核巩固期患者服药依从性及其影响因素研究. 护理学报, 2012, 19(23):12-15. doi:10.16460/j.issn1008-9969.2012.23.006.
[18]	姚媛英. 社区老年共病患者服药依从性及影响因素研究. 郑州: 河南大学, 2018.
[19]	Tola HH, Holakouie-Naieni K, Tesfaye E, et al. Prevalence of tuberculosis treatment non-adherence in Ethiopia: a systematic review and meta-analysis. Int J Tuberc Lung Dis, 2019, 23(6):741-749. doi:10.5588/ijtld.18.0672. pmid: 31315708
[20]	Marin PM, Munyeme M, Kankya C, et al. Medication nonadherence and associated factors in patients with tuberculosis in Wau, South Sudan: a cross-sectional study using the world health organization multidimensional adherence model. Arch Public Health, 2024, 82(1):107. doi:10.1186/s13690-024-01339-9.
[21]	Paikray E, Pattnaik M, Mishra V, et al. Evaluation of health-related quality of life and adherence among pre-extensively drug-resistant tuberculosis patients receiving either Bedaquiline or Delamanid regimen at a teaching hospital in Eastern India. J Family Med Prim Care, 2024, 13(10):4684-4692. doi:10.4103/jfmpc.jfmpc_572_24. pmid: 39629384
[22]	Lee H, Bea S, Kim JH, et al. Predictors, mortality, and health outcomes of intensive phase non-adherence to a regimen in patients with drug-susceptible tuberculosis: a nationwide linkage database. Public Health, 2024, 229:167-175. doi:10.1016/j.puhe.2024.01.021. pmid: 38452561
[23]	冯海霞. 巩固治疗期肺结核患者健康素养与服药依从性关系:病耻感的中介作用. 济南:山东大学, 2020. doi:10.27272/d.cnki.gshdu.2020.006158.
[24]	陈晗. 基于健康信念模式的健康教育对初复治肺结核患者心理困扰和服药依从行为的影响. 乌鲁木齐:新疆医科大学, 2022. doi:10.27433/d.cnki.gxyku.2022.001130.
[25]	王春雷, 金韬, 赵鹏鹏, 等. 江苏省淮安市耐多药肺结核患者服药依从性及影响因素分析. 中国防痨志, 2022, 44(10):1057-1062. doi:10.19982/j.issn.1000-6621.20220214.
[26]	蒋宇, 杨静, 吴茜, 等. 青年初治肺结核患者服药依从性及其影响因素研究. 中国实用护理杂志, 2023, 39(18): 1388-1395. doi:10.3760/cma.j.cn211501-20220527-01666.
[27]	孙杰莲, 潘秀云. 老年肺结核患者服药依从性调查及影响因素分析. 老年医学与保健, 2019, 25(6):770-773. doi:10.3969/j.issn.1008-8296.2019.06.023.
[28]	Shringarpure K, Gurumurthy M, Sagili KD, et al. Patient adherence to tuberculosis treatment in the Indian subcontinent: systematic review and meta-synthesis of qualitative research. BMJ Open, 2023, 13(5):e063926. doi:10.1136/bmjopen-2022-063926.
[29]	Chikovore J, Pai M, Horton KC, et al. Missing men with tuberculosis: the need to address structural influences and implement targeted and multidimensional interventions. BMJ Glob Health, 2020, 5(5):e002255. doi:10.1136/bmjgh-2019-002255.
[30]	Iweama CN, Agbaje OS, Umoke PCI, et al. Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study. SAGE Open Med, 2021, 9:2050312121989497. doi:10.1177/2050312121989497.
[31]	Gyimah FT, Dako-Gyeke P. Perspectives on TB patients’ care and support: a qualitative study conducted in Accra Metropolis, Ghana. Global Health, 2019, 15(1):19. doi:10.1186/s12992-019-0459-9.
[32]	Saqib SE, Ahmad MM, Panezai S. Care and social support from family and community in patients with pulmonary tuberculosis in Pakistan. Fam Med Community Health, 2019, 7(4):e000121. doi:10.1136/fmch-2019-000121.
[33]	Nirmal A, Kuzmik A, Sznajder K, et al. ‘If not for this support, I would have left the treatment!’: Qualitative study exploring the role of social support on medication adherence among pulmonary tuberculosis patients in Western India. Glob Public Health, 2022, 17(9):1945-1957. doi:10.1080/17441692.2021.1965182.
[34]	Helfinstein S, Engl E, Thomas BE, et al. Understanding why at-risk population segments do not seek care for tuberculosis: a precision public health approach in South India. BMJ Glob Health, 2020, 5(9):e002555. doi:10.1136/bmjgh-2020-002555.
[35]	Thomas BE, Suresh C, Lavanya J, et al. Understanding pretreatment loss to follow-up of tuberculosis patients: an explanatory qualitative study in Chennai, India. BMJ Glob Health, 2020, 5(2):e001974. doi:10.1136/bmjgh-2019-001974.
[36]	Yasobant S, Bhavsar P, Kalpana P, et al. Contributing Factors in the Tuberculosis Care Cascade in India: A Systematic Literature Review. Risk Manag Healthc Policy, 2021, 14:3275-3286. doi:10.2147/RMHP.S322143.
[37]	Zago PTN, Maffacciolli R, Mattioni FC, et al. Nursing actions promoting adherence to tuberculosis treatment: scoping review. Rev Esc Enferm USP, 2021, 55:e20200300. doi:10.1590/1980-220X-REEUSP-2020-0300.
[38]	Ravenscroft L, Kettle S, Persian R, et al. Video-observed therapy and medication adherence for tuberculosis patients: randomised controlled trial in Moldova. Eur Respir J, 2020, 56(2):2000493. doi:10.1183/13993003.00493-2020.
[39]	Pu J, Chen W, Jiang WX, et al. Is tuberculosis patients management improved in the integrated TB control model in West China? A survey in Guizhou Province, China. Infect Dis Poverty, 2019, 8(1):55. doi:10.1186/s40249-019-0563-3. pmid: 31262368
[40]	蒋学峰, 李静, 刘广天. 2015—2020年宁夏结核病疫情流行特征及空间分布. 宁夏医科大学学报, 2023(12):1276-1278,1290. doi:10.16050/j.cnki.issn1674-6309.2023.12.015.
[41]	谢芳晖, 雷丽梅, 姚蓉, 等. 含氯法齐明方案治疗的耐药肺结核患者身体意象与病耻感现状及其相关性研究. 中国实用护理杂志, 2023, 39(7): 486-491. doi:10.3760/cma.j.cn211501-20220411-01103.
[42]	Mohammedhussein M, Hajure M, Shifa JE, et al. Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study. PLoS One, 2020, 15(12):e0243433. doi:10.1371/journal.pone.0243433.
[43]	Nuttall C, Fuady A, Nuttall H, et al. Interventions pathways to reduce tuberculosis-related stigma: a literature review and conceptual framework. Infect Dis Poverty, 2022, 11(1):101. doi:10.1186/s40249-022-01021-8. pmid: 36138434
[44]	Craciun OM, Torres MDR, Llanes AB, et al. Tuberculosis Knowledge, Attitudes, and Practice in Middle- and Low-Income Countries: A Systematic Review. J Trop Med, 2023, 2023:1014666. doi:10.1155/2023/1014666.
[45]	Liu K, Zhang Y, Qu S, et al. Prevalence and Correlates of Anxiety and Depressive Symptoms in Patients With and Without Multi-Drug Resistant Pulmonary Tuberculosis in China. Front Psychiatry, 2021, 12:674891. doi:10.3389/fpsyt.2021.674891.
[46]	Sommerland N, Masquillier C, Rau A, et al. Reducing HIV-and TB-Stigma among healthcare co-workers in South Africa: Results of a cluster randomised trial. Soc Sci Med, 2020, 266:113450. doi:10.1016/j.socscimed.2020.113450.
[47]	Peddireddy V. Psychological interventions to improve the quality of life in Indian lung cancer patients: A neglected area. J Health Psychol, 2019, 24(1):100-112. doi:10.1177/1359105316650930. pmid: 27287601
[48]	Liu X, Bai X, Ren R, et al. Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study. Front Psychiatry, 2022, 13:985823. doi:10.3389/fpsyt.2022.985823.
[49]	Basham CA, Karim ME, Cook VJ, et al. Tuberculosis-associated depression: a population-based cohort study of people immigrating to British Columbia, Canada, 1985—2015. Ann Epidemiol, 2021, 63:7-14. doi:10.1016/j.annepidem.2021.06.002.
[50]	Wang XB, Li XL, Zhang Q, et al. A Survey of Anxiety and Depressive Symptoms in Pulmonary Tuberculosis Patients With and Without Tracheobronchial Tuberculosis. Front Psychiatry, 2018, 9:308. doi:10.3389/fpsyt.2018.00308.
[51]	Ruiz-Grosso P, Cachay R, de la Flor A, et al. Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis. PLoS One, 2020, 15(1):e0227472. doi:10.1371/journal.pone.0227472.
[52]	孙青峰, 李浩然, 逄宇, 等. 结核病与抑郁症共病的研究进展. 中国防痨杂志, 2024, 46 (1): 106-111. doi:10.19982/j.issn.1000-6621.20230381.
[53]	Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun, 2020, 89:594-600. doi:10.1016/j.bbi.2020.07.037. pmid: 32738287
[54]	Zhang K, Wang X, Tu J, et al. The interplay between depression and tuberculosis. J Leukoc Biol, 2019, 106(3):749-757. doi:10.1002/JLB.MR0119-023R.
[55]	Molebatsi K, Wang Q, Dima M, et al. Depression and delayed tuberculosis treatment initiation among newly diagnosed patients in Botswana. Glob Public Health, 2021, 16(7):1088-1098. doi:10.1080/17441692.2020.1826049.
[56]	王前, 王嘉, 刘二勇, 等. 《中国结核病患者关怀手册》专家解读. 中国防痨杂志, 2022, 44(1):49-53. doi:10.19982/j.issn.1000-6621.20210613.
[57]	Nadon H, Dmello MK, Shetty S. Factors determining family and social support among pulmonary tuberculosis patients in East Khasi Hills, Meghalaya: a cross-sectional study. J Public Health (Oxf), 2023:fdad063. doi:10.1093/pubmed/fdad063.
[58]	Wen S, Yin J, Sun Q. Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis. BMJ Open, 2020, 10(10):e036985. doi:10.1136/bmjopen-2020-036985.
[59]	文书琴. 耐药结核病患者治疗结局的健康社会决定因素分析:双向队列研究. 济南:山东大学, 2021. doi:10.27272/d.cnki.gshdu.2021.004026.
[60]	Bedingfield N, Lashewicz B, Fisher D, et al. Canadian tuberculosis health care workers’ perspectives on education and counselling for patients and family members who are born outside of Canada. Glob Public Health, 2023, 18(1):2174265. doi:10.1080/17441692.2023.2174265.
[61]	Petros de Guex K, Augustino D, Mejan P, et al. Roadblocks and resilience: A qualitative study of the impact of pediatric tuberculosis on Tanzanian households and solutions from caregivers. Glob Public Health, 2023, 18(1):2196569. doi:10.1080/17441692.2023.2196569.
[62]	王慧娟, 杜瑄, 刘晓慧, 等. 基于随机森林模型的产妇出院准备度影响因素分析. 中国医药导报, 2024, 21(23):87-91,101. doi:10.20047/j.issn1673-7210.2024.23.17.
[63]	Saidi SS, Abdul Manaf R. Effectiveness of family support health education intervention to improve health-related quality of life among pulmonary tuberculosis patients in Melaka, Malaysia. BMC Pulm Med, 2023, 23(1):139. doi:10.1186/s12890-023-02440-5. pmid: 37098515
[64]	Pradipta IS, Idrus LR, Probandari A, et al. Barriers and strategies to successful tuberculosis treatment in a high-burden tuberculosis setting: a qualitative study from the patient’s perspective. BMC Public Health, 2021, 21(1):1903. doi:10.1186/s12889-021-12005-y. pmid: 34670527
[65]	段林艳. 配偶同时赋能教育方案在肺结核出院患者中的应用研究. 新乡:新乡医学院, 2022. doi:10.27434/d.cnki.gxxyc.2022.000447.
[66]	Chiang SS, Senador L, Altamirano E, et al. Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru. BMJ Open, 2023, 13(5):e069938. doi:10.1136/bmjopen-2022-069938.
[67]	Zvonareva O, Witte S, Kabanets N, et al. Adolescents in a tuberculosis hospital: Qualitative study of how relationships with doctors, caregivers, and peers mediate their mental wellbeing. PLoS One, 2021, 16(10):e0257379. doi:10.1371/journal.pone.0257379.
[68]	Dixon EG, Rasool S, Otaalo B, et al. No action is without its side effects: Adverse drug reactions and missed doses of antituberculosis therapy, a scoping review. Br J Clin Pharmacol, 2024, 90(1):313-320. doi:10.1111/bcp.15908.
[69]	Thamineni R, Peraman R, Chenniah J, et al. Level of adhe-rence 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(11):1013-1023. doi:10.1111/tmi.13824.
[70]	Abbas S, Kermode M, Khan MD, et al. What Makes People With Chronic Illnesses Discontinue Treatment? A Practice Theory Informed Analysis of Adherence to Treatment among Patients With Drug-Resistant Tuberculosis in Pakistan. Int J Health Policy Manag, 2023, 12:6576. doi:10.34172/ijhpm.2022.6576. pmid: 37579474
[71]	梁艳蓉, 张爱洁, 俞南, 等. 抗结核药物不良反应报告分析. 中国医药, 2022, 17(12):1850-1853. doi:10.3760/j.issn.1673-4777.2022.12.020.
[72]	孟学兵, 陈爱军. 老年肺结核患者抗结核药物的不良反应研究. 中国防痨杂志, 2024, 46(z1):76-78.
[73]	Iskandar D, Suryanegara FDA, van Boven JFM, et al. Clinical pharmacy services for tuberculosis management: a systematic review. Front Pharmacol, 2023, 14:1186905. doi:10.3389/fphar.2023.1186905.
[74]	World Health Organization. Global tuberculosis report 2016. Geneva: World Health Organization, 2016.
[75]	Truong CB, Tanni KA, Qian J. Video-Observed Therapy Versus Directly Observed Therapy in Patients With Tuberculosis. Am J Prev Med, 2022, 62(3):450-458. doi:10.1016/j.amepre.2021.10.013.
[76]	Garfein RS, Doshi RP. Synchronous and asynchronous video observed therapy (VOT) for tuberculosis treatment adherence monitoring and support. J Clin Tuberc Other Mycobact Dis, 2019, 17:100098. doi:10.1016/j.jctube.2019.100098.
[77]	World Health Organization. Guidelines For Treatment Of Drug-susceptible Tuberculosis And Patient Care: 2017 Update. Geneva: World Health Organization, 2017.
[78]	张金静, 杨云云, 彭大利. 利用新技术提高结核病患者治疗依从性的研究进展. 中国全科医学, 2020, 23(1):114-119. doi:10.12114/j.issn.1007-9572.2019.00.361.
[79]	Liu X, Thompson J, Dong H, et al. Digital adherence technologies to improve tuberculosis treatment outcomes in China: a cluster-randomised superiority trial. Lancet Glob Health, 2023, 11(5):e693-e703. doi:10.1016/S2214-109X(23)00068-2. pmid: 37061308
[80]	Hou WL, Song FJ, Zhang NX, et al. Implementation and community involvement in DOTS strategy: a systematic review of studies in China. Int J Tuberc Lung Dis, 2012, 16(11):1433-1440. doi:10.5588/ijtld.12.0080. pmid: 23044444
[81]	Alipanah N, Jarlsberg L, Miller C, et al. Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies. PLoS Med, 2018, 15(7):e1002595. doi:10.1371/journal.pmed.1002595.
[82]	Li J, Pu J, Liu J, et al. Determinants of self-management behaviors among pulmonary tuberculosis patients: a path analysis. Infect Dis Poverty, 2021, 10(1):103. doi:10.1186/s40249-021-00888-3. pmid: 34330337
[83]	刘海妮, 张少茹, 华中秋, 等. 结核病患者自我管理的研究进展. 中国防痨杂志, 2019, 41 (7): 770-774. doi:10.3969/j.issn.1000-6621.2019.07.013.
[84]	Chen Y, Tan D, Xu Y, et al. Effects of a HAPA-based multicomponent intervention to improve self-management precursors of older adults with tuberculosis: A community-based randomised controlled trial. Patient Educ Couns, 2020, 103(2):328-335. doi:10.1016/j.pec.2019.09.007.
[85]	胡雪丹. 多学科团队协作护理干预在耐药肺结核患者自我管理中的应用研究. 南昌: 南昌大学医学部, 2021.
[86]	Khachadourian V, Truzyan N, Harutyunyan A, et al. People-centred care versus clinic-based DOT for continuation phase TB treatment in Armenia: a cluster randomized trial. BMC Pulm Med, 2020, 20(1):105. doi:10.1186/s12890-020-1141-y. pmid: 32334553
[87]	Mohr E, Snyman L, Mbakaz Z, et al. “Life continues”: Patient, health care and community care workers perspectives on self-administered treatment for rifampicin-resistant tuberculosis in Khayelitsha, South Africa. PLoS One, 2018, 13(9):e0203888. doi:10.1371/journal.pone.0203888.
[88]	Bao Y, Wang C, Xu H, et al. Effects of an mHealth Intervention for Pulmonary Tuberculosis Self-management Based on the Integrated Theory of Health Behavior Change: Randomized Controlled Trial. JMIR Public Health Surveill, 2022, 8(7):e34277. doi:10.2196/34277.