Adolescents account for an estimated 800,000 incident tuberculosis (TB) cases annually and are at risk for suboptimal adherence to TB treatment. Most studies of adolescent TB treatment adherence have used surveillance data with limited psychosocial information. This prospective cohort study aimed to identify risk factors for suboptimal adherence to rifampicin-susceptible TB treatment among adolescents (10-19 years old) in Lima, Peru. We collected psychosocial data using self-administered surveys and clinical data via medical record abstraction. Applying k-means cluster analysis, we grouped participants by psychosocial characteristics hypothesized to impact adherence. Then, we conducted mixed effects regression to compare suboptimal adherence-defined as <90% (missing >10% of doses)-between clusters. Treatment setting (facility vs. home) and drug formulation (single drug vs. fixed dose combination) were interaction terms. Of 249 participants, 90 (36.1%) were female. Median age was 17 (IQR: 15, 16.6) years. We identified three clusters-A, B, and C-of participants based on psychosocial characteristics. Cluster C had the lowest support from caregivers, other family members, and friends; had the weakest motivation to complete TB treatment; were least likely to live with their mothers; and had experienced the most childhood adversity. Among the 118 (47.4%) participants who received facility-based treatment with single drug formulations, adherence did not differ between Clusters A and B, but Cluster C had six-fold odds of suboptimal adherence compared to Cluster A. In Clusters B and C, adherence worsened over time, but only in Cluster C did mean adherence fall below 90% within six months. Our findings have implications for the care of adolescents with TB. When caring for adolescents with low social support and other risk factors, clinicians should take extra measures to reinforce adherence, such as identifying a community health worker or peer to provide treatment support. Implementing newly recommended shorter regimens also may facilitate adherence.
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http://dx.doi.org/10.1371/journal.pgph.0002918 | DOI Listing |
BMC Nurs
January 2025
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F, Esther Lee Building, Horse Material Water, Shatin, New Territories, Hong Kong SAR, China.
Background: Self-care practices among people with heart failure (HF) remain suboptimal. Nurse-led self-care interventions hold promise in managing this condition. The Common-Sense Model (CSM) of Self-Regulation is a widely adopted theoretical framework that promotes behavior change and improves disease prognosis among patients.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Medical Imaging, Children's Hospital at Westmead, Westmead, Australia; Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Background: Interventional neuroradiology is a dynamic field with technological advancements constantly driving evolution in clinical practice. Case series provide interventional neuroradiologists the opportunity to describe the clinical implications of novel equipment and techniques almost in real-time, informing broader adoption and directing future research. Complete reporting in case series is vital in enabling readers to detect bias, determine the generalizability of results and replicate study methodology.
View Article and Find Full Text PDFPharmacy (Basel)
January 2025
Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia.
Background: Correct inhaler technique is vital for managing respiratory conditions like asthma. Patients from culturally and linguistically diverse backgrounds are at higher risk of sub-optimal adherence and errors in inhaler technique. This study aimed to validate an Arabic version of the inhaler technique questionnaire for self-assessment of the metered-dose inhaler (MDI) technique by assessing agreement between observed and self-reported techniques among Arabic-speaking individuals with asthma in Australia.
View Article and Find Full Text PDFObjective: To assess the Knowledge, Attitudes and Practices (KAP) among healthcare professionals in managing patients with coexisting hypertension and bronchial asthma.
Design: A cross-sectional survey. The reporting of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
Cancer Nurs
January 2025
Author Affiliations: The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong (Ms Chen and Drs Ng, Zhang, and Chan); and Nursing Department, People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China (Ms Chen).
Background: Patients with gastrointestinal tract cancer reported suboptimal adherence to oral anticancer agents (OAAs), reducing their therapeutic benefit and increasing mortality risk. A scoping review can comprehensively map available evidence on adherence to OAAs and inform appropriate support to improve treatment outcomes.
Objective: The aim of this study was to comprehensively map studies on adherence to OAAs among adults with gastrointestinal tract cancer, including the adherence rate, nonadherence reasons, influential factors, management strategies, and theories that guide these studies.
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