Silent barriers: psycho-social factors and the hidden risk of medication non-adherence among tuberculosis patients in Mongolia

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI:10.1016/j.jctube.2026.100608

Munkhzaya Namsraijav , Basbish Tsogbadrakh , Orn-Anong Wichaikhum , Azadeh Stark

{"title":"Silent barriers: psycho-social factors and the hidden risk of medication non-adherence among tuberculosis patients in Mongolia","authors":"Munkhzaya Namsraijav , Basbish Tsogbadrakh , Orn-Anong Wichaikhum , Azadeh Stark","doi":"10.1016/j.jctube.2026.100608","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Medication non-adherence, potentially influenced by psychological and social factors, is a major barrier to effective treatment of tuberculosis. This study aimed to examine the associations between anxiety, depression, and social support with medication adherence.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted among 215 inpatients at the National Center for Communicable Diseases. Data were collected using Hospital Anxiety and Depression Scale (HADS), Medication Adherence Rating Scale (MARS), Oslo Social Support Scale (OSSS-3). Associations with medication adherence were examined using chi-squared tests and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the participants, 53.0% (n = 114) exhibited clinical signs of depression, and 44.2% (n = 95) had borderline or abnormal anxiety. Medication non-adherence was reported in 56.7% of patients. Abnormal anxiety was linked to a threefold higher risk of non-adherence (OR = 3.829, 95% CI = 1.495–9.807, P = 0.005). Poor (OR = 2.769, P = 0.024) and moderate (OR = 2.409, P = 0.043) social support also significantly increased risk. Depression was common but not significantly associated with adherence.</div></div><div><h3>Conclusion</h3><div>Anxiety and social support influence TB patients’ adherence with their treatment repertoire. Screening for anxiety and implementing interventions to enhance social and family support may improve adherence and optimize treatment outcomes in this patient population.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"43 ","pages":"Article 100608"},"PeriodicalIF":2.0000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405579426000306","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Medication non-adherence, potentially influenced by psychological and social factors, is a major barrier to effective treatment of tuberculosis. This study aimed to examine the associations between anxiety, depression, and social support with medication adherence.

Method

A cross-sectional study was conducted among 215 inpatients at the National Center for Communicable Diseases. Data were collected using Hospital Anxiety and Depression Scale (HADS), Medication Adherence Rating Scale (MARS), Oslo Social Support Scale (OSSS-3). Associations with medication adherence were examined using chi-squared tests and multivariable logistic regression.

Results

Among the participants, 53.0% (n = 114) exhibited clinical signs of depression, and 44.2% (n = 95) had borderline or abnormal anxiety. Medication non-adherence was reported in 56.7% of patients. Abnormal anxiety was linked to a threefold higher risk of non-adherence (OR = 3.829, 95% CI = 1.495–9.807, P = 0.005). Poor (OR = 2.769, P = 0.024) and moderate (OR = 2.409, P = 0.043) social support also significantly increased risk. Depression was common but not significantly associated with adherence.

Conclusion

Anxiety and social support influence TB patients’ adherence with their treatment repertoire. Screening for anxiety and implementing interventions to enhance social and family support may improve adherence and optimize treatment outcomes in this patient population.

查看原文本刊更多论文

无声的障碍：蒙古结核病患者服药不依从的心理社会因素和潜在风险

心理和社会因素对药物依从性的潜在影响是结核病有效治疗的主要障碍。本研究旨在探讨焦虑、抑郁和社会支持与药物依从性之间的关系。方法对国家传染病中心215例住院患者进行横断面研究。采用医院焦虑抑郁量表（HADS）、药物依从性评定量表（MARS）、奥斯陆社会支持量表（OSSS-3）收集数据。使用卡方检验和多变量逻辑回归检验与药物依从性的关系。结果53.0%（114人）表现出抑郁临床症状，44.2%（95人）有边缘性焦虑或异常焦虑。56.7%的患者出现药物不依从。异常焦虑与三倍的不依从性风险相关（OR = 3.829, 95% CI = 1.495-9.807, P = 0.005）。社会支持差（OR = 2.769, P = 0.024）和中等（OR = 2.409, P = 0.043）也显著增加风险。抑郁症很常见，但与依从性没有显著相关性。结论焦虑和社会支持影响结核病患者对治疗方案的依从性。筛查焦虑和实施干预措施，以加强社会和家庭的支持，可以提高依从性和优化治疗结果在这一患者群体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.