Latent tuberculous infection in the United                      States and Canada: Who completes treatment and why?

Y. Hirsch-Moverman; R. Shrestha-Kuwahara; J. Bethel; H. M. Blumberg; T. K. Venkatappa; C. R. Horsburgh; P. W. Colson; J. McAuley; J. Beison; J. Flood; K. Salcedo; R. Reves; K. Wall; H. Blumberg; J. Tapia; P. Colson; T. Venkatappa; W. Cronin; S. Collins; H. Rutz; R. Horsburgh; S. Etkind; S. Sharnprapai; S. Hughes; W. Miranda; T. Sterling; T. Stein-Hart; K. Gordon; M. Naus; K. Alasaly; S. Weis; G. Bayona; R. Horsburgh; S. Goldberg; H. Blumberg; P. Colson; C. Dukes-Hamilton; E. Eduardo; S. Hughes; H. Joseph; M. Nakajima; R. O'Brien; B. Roche; K. Salcedo; N. Selvam; K. Wall; P. Weinfurter; L. Yun.

doi:10.5588/ijtld.14.0373

Latent tuberculous infection in the United States and Canada: Who completes treatment and why?

Y. Hirsch-Moverman, R. Shrestha-Kuwahara, J. Bethel, H. M. Blumberg, T. K. Venkatappa, C. R. Horsburgh, P. W. Colson, J. McAuley, J. Beison, J. Flood, K. Salcedo, R. Reves, K. Wall, H. Blumberg, J. Tapia, P. Colson, T. Venkatappa, W. Cronin, S. Collins, H. RutzR. Horsburgh, S. Etkind, S. Sharnprapai, S. Hughes, W. Miranda, T. Sterling, T. Stein-Hart, K. Gordon, M. Naus, K. Alasaly, S. Weis, G. Bayona, R. Horsburgh, S. Goldberg, H. Blumberg, P. Colson, C. Dukes-Hamilton, E. Eduardo, S. Hughes, H. Joseph, M. Nakajima, R. O'Brien, B. Roche, K. Salcedo, N. Selvam, K. Wall, P. Weinfurter, L. Yun.

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVES: To assess latent tuberculous infection (LTBI) treatment completion rates in a large prospective US/Canada multisite cohort and identify associated risk factors.

METHODS: This prospective cohort study assessed factors associated with LTBI treatment completion through interviews with persons who initiated treatment at 12 sites. Interviews were conducted at treatment initiation and completion/cessation. Participants received usual care according to each clinic's procedure. Multivariable models were constructed based on stepwise assessment of potential predictors and interactions.

RESULTS: Of 1515 participants initiating LTBI treatment, 1323 had information available on treatment completion; 617 (46.6%) completed treatment. Baseline predictors of completion included male sex, foreign birth, not thinking it would be a problem to take antituberculosis medication, and having health insurance. Participants in stable housing who received monthly appointment reminders were more likely to complete treatment than those without stable housing or without monthly reminders. End-of-treatment predictors of noncompletion included severe symptoms and the inconvenience of clinic/pharmacy schedules, barriers to care and changes of residence. Common reasons for treatment non-completion were patient concerns about tolerability/toxicity, appointment conflicts, low prioritization of TB, and forgetfulness.

CONCLUSIONS: Less than half of treatment initiators completed treatment in our multisite study. Addressing tangible issues such as not having health insurance, toxicity concerns, and clinic accessibility could help to improve treatment completion rates.

Original language	English
Pages (from-to)	31-38
Number of pages	8
Journal	International Journal of Tuberculosis and Lung Disease
Volume	19
Issue number	1
DOIs	https://doi.org/10.5588/ijtld.14.0373
State	Published - 1 Jan 2015

Keywords

Adherence
Latent tuberculous infection
Prospective cohort
Treatment

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Hirsch-Moverman, Y., Shrestha-Kuwahara, R., Bethel, J., Blumberg, H. M., Venkatappa, T. K., Horsburgh, C. R., Colson, P. W., McAuley, J., Beison, J., Flood, J., Salcedo, K., Reves, R., Wall, K., Blumberg, H., Tapia, J., Colson, P., Venkatappa, T., Cronin, W., Collins, S., ... Yun., L. (2015). Latent tuberculous infection in the United States and Canada: Who completes treatment and why? International Journal of Tuberculosis and Lung Disease, 19(1), 31-38. https://doi.org/10.5588/ijtld.14.0373

@article{54ef0643e1014c42b52bed0b8bd02721,

title = "Latent tuberculous infection in the United States and Canada: Who completes treatment and why?",

abstract = "OBJECTIVES: To assess latent tuberculous infection (LTBI) treatment completion rates in a large prospective US/Canada multisite cohort and identify associated risk factors.METHODS: This prospective cohort study assessed factors associated with LTBI treatment completion through interviews with persons who initiated treatment at 12 sites. Interviews were conducted at treatment initiation and completion/cessation. Participants received usual care according to each clinic's procedure. Multivariable models were constructed based on stepwise assessment of potential predictors and interactions.RESULTS: Of 1515 participants initiating LTBI treatment, 1323 had information available on treatment completion; 617 (46.6%) completed treatment. Baseline predictors of completion included male sex, foreign birth, not thinking it would be a problem to take antituberculosis medication, and having health insurance. Participants in stable housing who received monthly appointment reminders were more likely to complete treatment than those without stable housing or without monthly reminders. End-of-treatment predictors of noncompletion included severe symptoms and the inconvenience of clinic/pharmacy schedules, barriers to care and changes of residence. Common reasons for treatment non-completion were patient concerns about tolerability/toxicity, appointment conflicts, low prioritization of TB, and forgetfulness.CONCLUSIONS: Less than half of treatment initiators completed treatment in our multisite study. Addressing tangible issues such as not having health insurance, toxicity concerns, and clinic accessibility could help to improve treatment completion rates.",

keywords = "Adherence, Latent tuberculous infection, Prospective cohort, Treatment",

author = "Y. Hirsch-Moverman and R. Shrestha-Kuwahara and J. Bethel and Blumberg, {H. M.} and Venkatappa, {T. K.} and Horsburgh, {C. R.} and Colson, {P. W.} and J. McAuley and J. Beison and J. Flood and K. Salcedo and R. Reves and K. Wall and H. Blumberg and J. Tapia and P. Colson and T. Venkatappa and W. Cronin and S. Collins and H. Rutz and R. Horsburgh and S. Etkind and S. Sharnprapai and S. Hughes and W. Miranda and T. Sterling and T. Stein-Hart and K. Gordon and M. Naus and K. Alasaly and S. Weis and G. Bayona and R. Horsburgh and S. Goldberg and H. Blumberg and P. Colson and C. Dukes-Hamilton and E. Eduardo and S. Hughes and H. Joseph and M. Nakajima and R. O'Brien and B. Roche and K. Salcedo and N. Selvam and K. Wall and P. Weinfurter and L. Yun.",

note = "Publisher Copyright: {\textcopyright} 2015 The Union.",

year = "2015",

month = jan,

day = "1",

doi = "10.5588/ijtld.14.0373",

language = "English",

volume = "19",

pages = "31--38",

journal = "International Journal of Tuberculosis and Lung Disease",

issn = "1027-3719",

publisher = "International Union Against Tuberculosis and Lung Disease (The Union)",

number = "1",

}

Hirsch-Moverman, Y, Shrestha-Kuwahara, R, Bethel, J, Blumberg, HM, Venkatappa, TK, Horsburgh, CR, Colson, PW, McAuley, J, Beison, J, Flood, J, Salcedo, K, Reves, R, Wall, K, Blumberg, H, Tapia, J, Colson, P, Venkatappa, T, Cronin, W, Collins, S, Rutz, H, Horsburgh, R, Etkind, S, Sharnprapai, S, Hughes, S, Miranda, W, Sterling, T, Stein-Hart, T, Gordon, K, Naus, M, Alasaly, K, Weis, S, Bayona, G, Horsburgh, R, Goldberg, S, Blumberg, H, Colson, P, Dukes-Hamilton, C, Eduardo, E, Hughes, S, Joseph, H, Nakajima, M, O'Brien, R, Roche, B, Salcedo, K, Selvam, N, Wall, K, Weinfurter, P & Yun., L 2015, 'Latent tuberculous infection in the United States and Canada: Who completes treatment and why?', International Journal of Tuberculosis and Lung Disease, vol. 19, no. 1, pp. 31-38. https://doi.org/10.5588/ijtld.14.0373

TY - JOUR

T1 - Latent tuberculous infection in the United States and Canada

T2 - Who completes treatment and why?

AU - Hirsch-Moverman, Y.

AU - Shrestha-Kuwahara, R.

AU - Bethel, J.

AU - Blumberg, H. M.

AU - Venkatappa, T. K.

AU - Horsburgh, C. R.

AU - Colson, P. W.

AU - McAuley, J.

AU - Beison, J.

AU - Flood, J.

AU - Salcedo, K.

AU - Reves, R.

AU - Wall, K.

AU - Blumberg, H.

AU - Tapia, J.

AU - Colson, P.

AU - Venkatappa, T.

AU - Cronin, W.

AU - Collins, S.

AU - Rutz, H.

AU - Horsburgh, R.

AU - Etkind, S.

AU - Sharnprapai, S.

AU - Hughes, S.

AU - Miranda, W.

AU - Sterling, T.

AU - Stein-Hart, T.

AU - Gordon, K.

AU - Naus, M.

AU - Alasaly, K.

AU - Weis, S.

AU - Bayona, G.

AU - Horsburgh, R.

AU - Goldberg, S.

AU - Blumberg, H.

AU - Colson, P.

AU - Dukes-Hamilton, C.

AU - Eduardo, E.

AU - Hughes, S.

AU - Joseph, H.

AU - Nakajima, M.

AU - O'Brien, R.

AU - Roche, B.

AU - Salcedo, K.

AU - Selvam, N.

AU - Wall, K.

AU - Weinfurter, P.

AU - Yun., L.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - OBJECTIVES: To assess latent tuberculous infection (LTBI) treatment completion rates in a large prospective US/Canada multisite cohort and identify associated risk factors.METHODS: This prospective cohort study assessed factors associated with LTBI treatment completion through interviews with persons who initiated treatment at 12 sites. Interviews were conducted at treatment initiation and completion/cessation. Participants received usual care according to each clinic's procedure. Multivariable models were constructed based on stepwise assessment of potential predictors and interactions.RESULTS: Of 1515 participants initiating LTBI treatment, 1323 had information available on treatment completion; 617 (46.6%) completed treatment. Baseline predictors of completion included male sex, foreign birth, not thinking it would be a problem to take antituberculosis medication, and having health insurance. Participants in stable housing who received monthly appointment reminders were more likely to complete treatment than those without stable housing or without monthly reminders. End-of-treatment predictors of noncompletion included severe symptoms and the inconvenience of clinic/pharmacy schedules, barriers to care and changes of residence. Common reasons for treatment non-completion were patient concerns about tolerability/toxicity, appointment conflicts, low prioritization of TB, and forgetfulness.CONCLUSIONS: Less than half of treatment initiators completed treatment in our multisite study. Addressing tangible issues such as not having health insurance, toxicity concerns, and clinic accessibility could help to improve treatment completion rates.

AB - OBJECTIVES: To assess latent tuberculous infection (LTBI) treatment completion rates in a large prospective US/Canada multisite cohort and identify associated risk factors.METHODS: This prospective cohort study assessed factors associated with LTBI treatment completion through interviews with persons who initiated treatment at 12 sites. Interviews were conducted at treatment initiation and completion/cessation. Participants received usual care according to each clinic's procedure. Multivariable models were constructed based on stepwise assessment of potential predictors and interactions.RESULTS: Of 1515 participants initiating LTBI treatment, 1323 had information available on treatment completion; 617 (46.6%) completed treatment. Baseline predictors of completion included male sex, foreign birth, not thinking it would be a problem to take antituberculosis medication, and having health insurance. Participants in stable housing who received monthly appointment reminders were more likely to complete treatment than those without stable housing or without monthly reminders. End-of-treatment predictors of noncompletion included severe symptoms and the inconvenience of clinic/pharmacy schedules, barriers to care and changes of residence. Common reasons for treatment non-completion were patient concerns about tolerability/toxicity, appointment conflicts, low prioritization of TB, and forgetfulness.CONCLUSIONS: Less than half of treatment initiators completed treatment in our multisite study. Addressing tangible issues such as not having health insurance, toxicity concerns, and clinic accessibility could help to improve treatment completion rates.

KW - Adherence

KW - Latent tuberculous infection

KW - Prospective cohort

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=84918777756&partnerID=8YFLogxK

U2 - 10.5588/ijtld.14.0373

DO - 10.5588/ijtld.14.0373

M3 - Article

C2 - 25519787

AN - SCOPUS:84918777756

SN - 1027-3719

VL - 19

SP - 31

EP - 38

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 1

ER -

Latent tuberculous infection in the United States and Canada: Who completes treatment and why?

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Keywords

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