The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study

Objectives: There is scant qualitative research into the experiences of tuberculosis (TB) treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalized groups attending a major TB centre in Lon...

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Main Authors: Gillian M. Craig, Alimuddin Zumla
Format: Article
Language:English
Published: Elsevier 2015-03-01
Series:International Journal of Infectious Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971215000120
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author Gillian M. Craig
Alimuddin Zumla
author_facet Gillian M. Craig
Alimuddin Zumla
author_sort Gillian M. Craig
collection DOAJ
description Objectives: There is scant qualitative research into the experiences of tuberculosis (TB) treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalized groups attending a major TB centre in London. Methods: A qualitative cross-sectional study was performed using semi-structured interviews with patients receiving treatment for TB. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results: There were 17 participants; the majority were homeless and had complex medical and social needs, including drug and alcohol use or immigration problems affecting entitlement to social welfare. Participants rarely actively chose not to take their medication, but described a number of social and institutional barriers to adherence and their need for practical support. Many struggled with the physical aspects of taking medication and the side effects. Participants receiving directly observed therapy (DOT) reported both positive and negative experiences, reflecting the type of DOT provider and culture of the organization. Conclusions: There is a need for integrated care across drug, alcohol, HIV, and homeless services in order to address the complex clinical co-morbidities and social needs that impact on the patient's ability to sustain a course of treatment.
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spelling doaj.art-46fb58428b8446bca8a1f5093340326a2022-12-22T01:44:47ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112015-03-0132C10511010.1016/j.ijid.2015.01.007The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview studyGillian M. Craig0Alimuddin Zumla1School of Health Sciences, City University London, Northampton Square, London, EC1 V 0HB, UKDepartment of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, and NIHR Biomedical Research Centre, University College London Hospitals, London, UKObjectives: There is scant qualitative research into the experiences of tuberculosis (TB) treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalized groups attending a major TB centre in London. Methods: A qualitative cross-sectional study was performed using semi-structured interviews with patients receiving treatment for TB. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results: There were 17 participants; the majority were homeless and had complex medical and social needs, including drug and alcohol use or immigration problems affecting entitlement to social welfare. Participants rarely actively chose not to take their medication, but described a number of social and institutional barriers to adherence and their need for practical support. Many struggled with the physical aspects of taking medication and the side effects. Participants receiving directly observed therapy (DOT) reported both positive and negative experiences, reflecting the type of DOT provider and culture of the organization. Conclusions: There is a need for integrated care across drug, alcohol, HIV, and homeless services in order to address the complex clinical co-morbidities and social needs that impact on the patient's ability to sustain a course of treatment.http://www.sciencedirect.com/science/article/pii/S1201971215000120TuberculosisSocial determinantsAdherenceHomeless personsDrug usersStigma
spellingShingle Gillian M. Craig
Alimuddin Zumla
The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
International Journal of Infectious Diseases
Tuberculosis
Social determinants
Adherence
Homeless persons
Drug users
Stigma
title The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
title_full The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
title_fullStr The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
title_full_unstemmed The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
title_short The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
title_sort social context of tuberculosis treatment in urban risk groups in the united kingdom a qualitative interview study
topic Tuberculosis
Social determinants
Adherence
Homeless persons
Drug users
Stigma
url http://www.sciencedirect.com/science/article/pii/S1201971215000120
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