Counseling intervention improves treatment adherence among newly diagnosed drug sensitive Tuberculosis patients of Ahmedabad city – A mixed methods approach

Introduction

Counselling sessions based on the health behaviour module for patients on TB treatment may help improve the level of understanding of tuberculosis and its treatment, importance of adherence to therapy, possible side effects, dietary habits and to address any misconceptions; leading to better adherence and improved outcome. Hence, study attempted to assess the impact of brief counselling intervention through treatment adherence supportive activist (TASA) in improving adherence to treatment among drug sensitive TB patients.

Methods

An explanatory mixed methods design (QUAN-Qual) was carried out. Out of 23 Tuberculosis units (TUs) in Ahmedabad Municipal Corporation (AMC) two were selected, one interventional group where trained counsellor was recruited while other was the control group. All drug sensitive TB patients diagnosed at both selected TUs during January to March 2020 were included in the study. Among all patients who were non-adherent in both the TUs, 14 were selected to explore factors contributing to non-adherence to treatment.

Results

At the end of intensive phase, drug adherence in the study TU was 85.71% while it was 67.5% in the control TU. At the end of one month of treatment, the proportion of patients having better level adherence was more among counselled patients as compared to non-counselled patients. Marital status, religion, gender did not affect the level of adherence. Reasons for non-adherence as well as perceived barriers to adherence to TB treatment were treatment related, patient related and social barriers.

Conclusion

Dedicated NTEP counsellor (TASA) can help improve the treatment adherence and impact of physical counselling.