Factors That Influence Treatment Completion for Latent Tuberculosis Infection

J Am Board Fam Med. 2017 Jul-Aug;30(4):520-527. doi: 10.3122/jabfm.2017.04.170070.

Abstract

Introduction: The aim of this study is to describe factors associated with noncompletion of latent tuberculosis infection (LTBI) therapy.

Methods: We conducted a retrospective cohort study of adults who initiated LTBI treatment with isoniazid, rifampin, or isoniazid-rifapentine at 5 clinics. Demographic, treatment, and monitoring characteristics were abstracted. We estimated descriptive statistics and compared differences between completers and noncompleters using t tests and χ2 tests.

Results: The rate of completion across LTBI regimens was 66% (n = 393). A greater proportion of noncompleters were unmarried, used tobacco and/or alcohol, and had more medical problems than completers (all P < .05). A larger proportion of noncompleters received charity care compared with completers (P < .001). The most common reason for treatment discontinuation was loss to follow-up; the majority of these participants were treated with the longest isoniazid-only regimen.

Conclusions: Patients at risk of progression to active tuberculosis with factors associated with noncompletion may benefit from interventions that enhance adherence to LTBI therapy. These interventions could include enhanced outreach, incentive programs, or home visits.

Keywords: Antitubercular Agents; Isoniazid; Latent Tuberculosis; Motivation; Retrospective Studies; Rifampin; Rifapentine.

MeSH terms

  • Adult
  • Antitubercular Agents / administration & dosage*
  • Female
  • Humans
  • Latent Tuberculosis / drug therapy*
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Retrospective Studies

Substances

  • Antitubercular Agents