Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru
Objectives To understand the perspectives of adolescents (10–19 years old), their caregivers and healthcare providers regarding factors that impact adherence to tuberculosis (TB) treatment among adolescents.Design We conducted in-depth interviews using semistructured interview guides based on the Wo...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/5/e069938.full |
| _version_ | 1827180775433306112 |
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| author | Leonid Lecca Stephanie Roche Jerome T Galea Victoria Elena Oliva Rapoport Elmer Altamirano Liz Senador Milagros Wong Catherine B Beckhorn Julia Coit Silvia S Chiang |
| author_facet | Leonid Lecca Stephanie Roche Jerome T Galea Victoria Elena Oliva Rapoport Elmer Altamirano Liz Senador Milagros Wong Catherine B Beckhorn Julia Coit Silvia S Chiang |
| author_sort | Leonid Lecca |
| collection | DOAJ |
| description | Objectives To understand the perspectives of adolescents (10–19 years old), their caregivers and healthcare providers regarding factors that impact adherence to tuberculosis (TB) treatment among adolescents.Design We conducted in-depth interviews using semistructured interview guides based on the World Health Organization (WHO)’s Five Dimensions of Adherence framework, which conceptualises adherence as being related to the health system, socioeconomic factors, patient, treatment and condition. We applied framework thematic analysis.Setting Between August 2018 and May 2019, at 32 public health centres operated by the Ministry of Health in Lima, Peru.Participants We interviewed 34 adolescents who completed or were lost to follow-up from treatment for drug-susceptible pulmonary TB disease in the preceding 12 months; their primary caregiver during treatment; and 15 nurses or nurse technicians who had ≥6 months’ experience supervising TB treatment.Results Participants reported numerous treatment barriers, the most common of which were the inconvenience of health facility-based directly observed therapy (DOT), long treatment duration, adverse treatment events and symptom resolution. The support of adult caregivers was critical for helping adolescents overcome these barriers and carry out the behavioural skills (eg, coping with the large pill burden, managing adverse treatment events and incorporating treatment into daily routines) needed to adhere to treatment.Conclusion Our findings support a three-pronged approach to improve TB treatment adherence among adolescents: (1) reduce barriers to adherence (eg, home-based or community-based DOT in lieu of facility-based DOT, reducing pill burden and treatment duration when appropriate), (2) teach adolescents the behavioural skills required for treatment adherence and (3) strengthen caregivers’ ability to support adolescents. |
| first_indexed | 2024-03-13T10:30:10Z |
| format | Article |
| id | doaj.art-98219558573a417ea548bac1d89b39ef |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-21T05:36:16Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-98219558573a417ea548bac1d89b39ef2024-07-24T17:30:08ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2022-069938Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, PeruLeonid Lecca0Stephanie Roche1Jerome T Galea2Victoria Elena Oliva Rapoport3Elmer Altamirano4Liz Senador5Milagros Wong6Catherine B Beckhorn7Julia Coit8Silvia S Chiang9Socios En Salud Sucursal Peru, Lima, PeruDivision of Public Health Sciences, Fred Hutchinson Cancer Research Institute, Seattle, Washington, USADepartment of Social Work, University of South Florida, Tampa, Florida, USADepartment of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USASocios En Salud Sucursal Peru, Lima, PeruSocios En Salud Sucursal Peru, Lima, PeruSocios En Salud Sucursal Peru, Lima, PeruSocios En Salud Sucursal Peru, Lima, PeruDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USADepartment of Pediatrics, Division of Pediatric Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USAObjectives To understand the perspectives of adolescents (10–19 years old), their caregivers and healthcare providers regarding factors that impact adherence to tuberculosis (TB) treatment among adolescents.Design We conducted in-depth interviews using semistructured interview guides based on the World Health Organization (WHO)’s Five Dimensions of Adherence framework, which conceptualises adherence as being related to the health system, socioeconomic factors, patient, treatment and condition. We applied framework thematic analysis.Setting Between August 2018 and May 2019, at 32 public health centres operated by the Ministry of Health in Lima, Peru.Participants We interviewed 34 adolescents who completed or were lost to follow-up from treatment for drug-susceptible pulmonary TB disease in the preceding 12 months; their primary caregiver during treatment; and 15 nurses or nurse technicians who had ≥6 months’ experience supervising TB treatment.Results Participants reported numerous treatment barriers, the most common of which were the inconvenience of health facility-based directly observed therapy (DOT), long treatment duration, adverse treatment events and symptom resolution. The support of adult caregivers was critical for helping adolescents overcome these barriers and carry out the behavioural skills (eg, coping with the large pill burden, managing adverse treatment events and incorporating treatment into daily routines) needed to adhere to treatment.Conclusion Our findings support a three-pronged approach to improve TB treatment adherence among adolescents: (1) reduce barriers to adherence (eg, home-based or community-based DOT in lieu of facility-based DOT, reducing pill burden and treatment duration when appropriate), (2) teach adolescents the behavioural skills required for treatment adherence and (3) strengthen caregivers’ ability to support adolescents.https://bmjopen.bmj.com/content/13/5/e069938.full |
| spellingShingle | Leonid Lecca Stephanie Roche Jerome T Galea Victoria Elena Oliva Rapoport Elmer Altamirano Liz Senador Milagros Wong Catherine B Beckhorn Julia Coit Silvia S Chiang Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru BMJ Open |
| title | Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru |
| title_full | Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru |
| title_fullStr | Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru |
| title_full_unstemmed | Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru |
| title_short | Adolescent, caregiver and provider perspectives on tuberculosis treatment adherence: a qualitative study from Lima, Peru |
| title_sort | adolescent caregiver and provider perspectives on tuberculosis treatment adherence a qualitative study from lima peru |
| url | https://bmjopen.bmj.com/content/13/5/e069938.full |
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