Social support and incentives programme for patients with tuberculosis: experience from the Russian Federation.

SETTING

Tuberculosis (TB) services including social support and incentive programmes in four Russian regions (Orel, Vladimir, Belgorod Oblasts and Republic of Mari-El).

OBJECTIVES

To determine reasons for TB treatment default among non-adherent patients and to describe patient views of social support programmes and the organisation of treatment.

METHODS

Standard anonymous questionnaires were administered to new pulmonary TB patients registered for treatment.

RESULTS

A total of 87 non-adherent patients and 1302 adherent patients were interviewed. The leading reasons for treatment default given by non-adherent patients were the need to earn money (30%), alcohol use (30%) and not perceiving themselves as being sick (25%). Monetary incentives were preferred by the majority of patients (67%), followed by food/hot meals (41%) and transportation reimbursement (32%). Overall, among the proposed social support programmes, those that offered small daily incentives (23%) or a big final bonus (21%) were the most popular. The majority of patients (67%) preferred out-patient treatment.

CONCLUSION

Collaboration between TB services and social organisations and substance abuse services as well as availability of psychological testing/counselling for patients are social support modalities for improving adherence suggested by study findings. Social support should be combined with a patient-centred approach to TB treatment.