Factors Influencing Non-adherence to Treatment Among New Patients With Tuberculosis in the Field Practice Area of a Tertiary Care Hospital in Hyderabad: A Cross-Sectional Study.

INTRODUCTION: Tuberculosis (TB) is an infectious disease caused by(MT), which primarily affects the lungs (pulmonary tuberculosis) but can also involve other organs, such as bone, lymph nodes, brain, and kidney (extrapulmonary tuberculosis). Although it is a curable and preventable disease, it continues to be a major public health problem. Adherence to therapy plays an important role in treatment outcome. The objectives are to study the prevalence of non-adherence to anti-tuberculosis treatment among new patients with pulmonary tuberculosis in the field practice area of a tertiary care hospital in Hyderabad and to determine the factors influencing non-adherence to treatment among new patients with pulmonary tuberculosis.

METHODOLOGY: A community-based cross-sectional study was carried out in the field practice areas of Osmania Medical College, Hyderabad, between October 2020 and March 2021. All newly diagnosed patients with pulmonary tuberculosis registered under Directly Observed Treatment Short-Course (DOTS) from October 2020 to March 2021 were taken into the study. Taking the prevalence of non-adherence to anti-tuberculosis treatment as 50% and absolute error as 5% with 95% confidence interval, the sample size was calculated as 385, and the participants were chosen by simple random sampling. A predesigned, pretested, and semi-structured questionnaire was used for collecting data on sociodemographic and socioeconomic factors, clinical characteristics, and factors influencing non-adherence to treatment, such as patient-related factors, health system-related factors, stigma/discrimination, disease-related factors, and medicine-related factors, by interviewing the patients.

RESULTS: The mean age of the study population was 43 years. Of the patients, 77.7% (299) were men and 22.3% (86) were women. In this study, 19.48% of the study participants had non-adherence to treatment. Socioeconomic status, educational status, marital status, side effects of drugs, awareness about treatment completion, and smoking were significantly associated with non-adherence to treatment.

CONCLUSION:  Marital status, educational status, smoking, and socioeconomic constraints contribute to poor adherence. Improving adherence to treatment requires a comprehensive, patient-centered approach that combines health education, counselling, social support, and strengthened healthcare delivery systems.