对利福平敏感的抗结核治疗错过剂量的时间复杂性:坦桑尼亚的一项前瞻性队列研究。

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Lilian Tuwabunze, Kassim Salim Msaji, Alphonce Liyoyo, Proma Paul, Stellah Mpagama, Helen R Stagg
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引用次数: 0

摘要

背景:不遵守抗结核(TB)方案并不是简单的;相反,剂量以复杂的模式被遗漏。在坦桑尼亚接受利福平敏感性肺结核治疗的个体队列中,我们试图检查在整个治疗过程和一天内如何漏给剂量,以及漏给剂量期的原因。方法:从2022年3月至2023年6月招募200名年龄≥18岁的患者,接受标准6个月方案治疗。用evriMED药盒和药片计数来测量漏服剂量。收集了每月多达三次错过给药期的原因。错过剂量的模式——在整个治疗过程中和一天内——以及它们的原因被可视化和描述。研究结果:两名参与者在治疗早期死亡,留下198名遗漏剂量数据。随着时间的推移,错过任何给定剂量的参与者百分比的增加是由于治疗的早期停药(第1个月中位剂量错过0.0%,第6个月错过6.7%),而不是零星错过剂量(第1个月中位剂量错过3.1%,第6个月中位剂量错过4.1%)。每名参与者有1次偶发性遗漏剂量期(剂量长度在0至42剂之间)。在所有报告的错过剂量期的原因中,忘记或忘记和不方便是最常见的(59.6%)。解释:缺少抗结核治疗剂量是一种暂时的复杂现象,是个人生活中多方面日常事件交叉的结果,对整个治疗过程中的有效药物水平具有复杂的影响。这种复杂性限制了我们在治疗开始时预测个体遗漏剂量的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.

Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.

Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.

Temporal complexity in missed doses of rifampicin-sensitive anti-tuberculosis treatment: a prospective cohort study in Tanzania.

Background: Non-adherence to anti-tuberculosis (TB) regimens is not simplistic; rather, doses are missed in complex patterns. In a cohort of individuals being treated for rifampicin-sensitive pulmonary TB in Tanzania, we sought to examine how doses were missed across the treatment course and within a day, as well as the reasons for missed dose periods.

Methods: 200 participants aged ≥18 years treated with the standard 6-month regimen were recruited from March 2022 to June 2023. Missed doses were measured using evriMED pillboxes and by pill count. The reasons for up to three missed dose periods per month were collected. Patterns of missed doses-across treatment and within a day-and their reasons were visualised and described.

Findings: Two participants died early in treatment, leaving 198 with missed dose data. The increase in the percentage of participants that missed any given dose as time progressed was driven by early discontinuation (median doses missed 0.0% in month 1 vs 6.7% in month 6) from treatment, as opposed to sporadic missed doses (median doses missed 3.1% in month 1 vs 4.1% in month 6). There was a median of one sporadic missed dose period (ranging between 0 and 42 doses in length) per participant. Out of all the reported reasons for missed dose periods, forgetting or forgetting and inconvenience were the most common (59.6%).

Interpretation: Missing doses of anti-TB treatment is a temporally complex phenomenon and the result of the intersection of multifaceted day-to-day events in an individual's life, with complicated implications for effective drug levels across the treatment course. This complexity limits our ability to predict an individual's missed doses at the start of treatment.

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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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