Patients' acceptability, adherence and satisfaction on the modified shorter all-oral multidrug-resistant tuberculosis regimen: a two-phase cross-sectional study in Tanzania

Abstract

Objectives: To determine patients' acceptability, satisfaction and adherence to shorter all-oral multidrug-resistant tuberculosis (MDR-TB) regimen in Tanzania.

Design: A two-phase cross-sectional study with data collected within 6 months of Removed Injectable modified Short-course regimens for EXpert MDR-TB (RISE) study implementation and the second phase within 15 months of implementation using the same reference populations.

Settings: 18 health facilities across eight regions of Tanzania.

Participants: Rifampicin-resistant TB/MDR-TB patients enrolled in the RISE study.

Outcome measures: We assessed patients' acceptability, adherence and satisfaction with the regimen using an interval scale structured questionnaire.

Results: The majority of the patients found the shorter oral MDR-TB treatment acceptable, adhered to it well and were generally satisfied. The median score (IQR) for acceptability was 1.7 (1.03-2.00) but it ranged between 1.3 (1.3-2) and 1.7 (1-1.79) for the first and second phases, respectively. Regarding adherence, the median score (IQR) stood at 4 (3.67-4.67) with scores significantly higher in the second phase at 4.33 (4.00-5.007) compared with the first at 4.67 (4.00-5.0), p value=0.01. The overall satisfaction was high at 1.5 (1.33-1.78) but it ranged between 1.22 (1.00-1.78) and 1.42 (1.11-1.78) for the first and second phases, respectively. Worrying about side effects was statistically associated with adherence (p value<0.05). No statistically significant associations were found for acceptability and satisfaction.

Conclusion: Generally, the modified shorter oral MDR-TB regimen was accepted, and patients reported good adherence and were satisfied. More engagement with patients could provide more insights into factors that can maximise acceptability, adherence and satisfaction with the regimen.

Keywords: Medication Adherence; Patient Satisfaction; Tuberculosis.