Medication adherence among patients on concomitant tuberculosis and antiretroviral regimen in a tertiary care teaching hospital

Abstract

BACKGROUND AND OBJECTIVES: Treatment of HIV–tuberculosis (TB) coinfected patients requires antitubercular and antiretroviral drugs to be administered concomitantly; challenges include pill burden, patient compliance, drug interactions, etc. The present study is planned to assess and compare the rate of adherence to TB medicines and antiretroviral therapy (ART) in patients with HIV–TB coinfection. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was carried out in the ART clinic of a tertiary care teaching hospital in 146 patients of acquired immunodeficiency syndrome coinfected with TB. Adherence to therapy was assessed using the Morisky eight-item medication adherence questionnaire. RESULTS: One hundred and forty-six patients participated in the study, of which 102 participants forgot to take the TB medication and 82 of the participants forgot to take ART sometimes. Furthermore, 78 participants did not take TB medicine, while 57 did not take ART in the past 2 weeks for reasons other than forgetfulness. These results were statistically significant. The sociodemographic factor significantly associated with low adherence to ART was addiction. In the Morisky eight-item medication adherence to TB drugs, 0.68% of patients showed high adherence, 17.8% of patients showed medium adherence, and 81.5% showed low adherence, whereas for ARV medicines, 0.68% of patients showed high adherence, 18.49% of patients showed medium adherence, and 80.82% showed low adherence. CONCLUSION: Adherence level obtained in this study was relatively low for both ARV and TB treatment. Patient’s affordability and forgetfulness are the major causes of nonadherence. Similarly, addiction is also one of the important causes of nonadherence to ARV treatment in our study.