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. 2023 Jul 6;9(7):e17975.
doi: 10.1016/j.heliyon.2023.e17975. eCollection 2023 Jul.

Factors affecting treatment adherence among leprosy patients: Perceptions of healthcare providers

Veincent Christian F Pepito  1   2 , Arianna Maever Loreche  1   2   3 , Rae Erica D Samontina  1   2 , Sarah Jane A Abdon  1   4 , David Norman L Fuentes  1   5 , Ofelia P Saniel  1   6
Affiliations

Factors affecting treatment adherence among leprosy patients: Perceptions of healthcare providers

Veincent Christian F Pepito et al. Heliyon. .

Abstract

Background: Treatment adherence is a vital aspect in the management of chronic diseases like leprosy; however, most studies on treatment adherence focus on patients. This study aims to examine the perceptions of healthcare providers on factors that can promote or prevent patients from adhering to treatment.

Methods: We conducted three focus group discussions (FGDs) with healthcare providers who have at least one year experience in managing leprosy in three large leprosy case-holding hospitals in Metro Manila, Philippines. We audio-recorded, transcribed, translated the FGD proceedings, and analyzed the transcripts thematically to identify patient-intrinsic and patient-extrinsic enablers and barriers to treatment adherence of leprosy patients.

Results: Patient-intrinsic motivators to complete treatment include innate desire to be cured, fear of infecting family and friends, fear of disability, good knowledge about the disease, need for medical clearance to be considered fit to work, and experiencing leprosy reactions. Patient-extrinsic motivators to complete treatment include free treatment, immediate and sufficient counselling, flexibility in treatment, follow-up and motivation of healthcare workers, and presence of Hansen's Club and support groups. Patient-intrinsic barriers to good treatment adherence include distance between residence and hospital, financial and opportunity costs, adverse drug reactions, misconceptions about being cured, disabilities and presence of leprosy reactions, stubbornness and/or laziness, and undergoing clinical depression. Patient-extrinsic barriers to good treatment adherence include poor availability of MDT, transfer to other leprosy treatment facilities without informing current facility, and stigma.

Conclusion: Healthcare providers perceive that patient-intrinsic and patient-extrinsic factors influence the treatment adherence of leprosy patients through different mechanisms. We highlight the role of healthcare provider attitudes, stigma, and support groups in promoting treatment adherence.

Keywords: Healthcare providers; Leprosy; Philippines; Primary care; Qualitative study; Treatment adherence.

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Conflict of interest statement

VCFP and AML received funding from Sanofi Consumer Healthcare to conduct research on self-care. They have also received funding from the International Initiative for Impact Evaluation, Inc. (3ie) to propose a study on programs designed by the Philippine Health Insurance Corporation. VCFP is an advisory board member of Heliyon. Other authors have no conflicts of interest to disclose.

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