Influence of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: research protocol.

Aim: To evaluate the efficacy of nursing interventions on adherence to antituberculosis medication in a paediatric cohort (aged 0-18 years) and to identify the risk factors for non-compliance.

Background: After primary infection, children have a higher risk of developing tuberculosis and the severity of the disease is worse in children. Adherence to treatment is essential to control both latent infection and tuberculosis disease.

Design: Phase 1: retrospective descriptive analysis (n = 270) in children and young people receiving antituberculosis treatment. Phase 2: quasi-experimental, longitudinal, prospective study (n = 100). The results of the two phases will be compared.

Methods: Phase 1: in children followed up during the period 2011-2013 (non-intervention group), the level of adherence and its associated epidemiological, sociocultural and clinical risk factors will be analysed. Phase 2: educational (written information in the child's mother tongue and follow-up telephone calls) and monitoring (Eidus-Hamilton test and follow-up questionnaire) nursing interventions will be implemented. The results of the two phases will be compared. The definitive Nurse-led Follow-up Programme will then be designed. This project was funded in October 2013.

Discussion: The risk factors for poor adherence to antituberculosis therapy need to be identified to optimize treatment success in latent tuberculosis infection and disease in children and young people. Simultaneous application of several educational and monitoring methods in nurse-led follow-up shall improve adherence in children and adolescents in our setting. These results may also be applicable in other settings, where tuberculosis is more prevalent and directly observed treatment strategies are not available.