Graduate Program in Pulmonology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
J Bras Pneumol. 2011 Nov-Dec;37(6):776-82. doi: 10.1590/s1806-37132011000600011.
To determine the predictors of noncompliance with the pulmonary tuberculosis treatment regimen recommended by the Brazilian National Ministry of Health, in previously treatment-naïve patients with active tuberculosis treated in the city of Porto Alegre, Brazil.
This was a case-control study involving six referral primary health care clinics for tuberculosis in Porto Alegre. We reviewed the medical charts of all previously treatment-naïve patients with active pulmonary tuberculosis who were noncompliant with the treatment between 2004 and 2006. Those were paired with other patients having similar characteristics and having been cured. We conducted univariate and multivariate analyses.
Of the 2,098 patients included, 218 (10.4%) became noncompliant with the treatment. In the multivariate analysis, the factors most strongly associated with treatment noncompliance were being an alcoholic (with or without concomitant use of illicit drugs), being HIV-infected, not residing with family members, and having a low level of education. In the univariate analysis, treatment noncompliance was also significantly associated with being younger and with being non-White. Gender was not significantly associated with treatment noncompliance; nor was the occurrence of adverse effects of the drugs included in the regimen.
In the population studied, being an alcoholic, being HIV-infected, and not residing with family members were the major predictors of noncompliance with treatment for pulmonary tuberculosis among previously treatment-naïve patients.
确定巴西卫生部推荐的肺结核治疗方案在巴西阿雷格里港治疗的初治活动性肺结核患者中不遵医行为的预测因素。
这是一项病例对照研究，涉及阿雷格里港的六家转诊肺结核初级保健诊所。我们回顾了 2004 年至 2006 年期间不遵医嘱治疗的所有初治活动性肺结核且未经治疗的患者的病历。将这些患者与具有相似特征且已治愈的其他患者进行配对。我们进行了单变量和多变量分析。
在 2098 名患者中，有 218 名（10.4%）不遵医嘱治疗。在多变量分析中，与治疗不依从性最密切相关的因素是酗酒（无论是否同时使用非法药物）、感染艾滋病毒、不与家庭成员同住以及受教育程度低。在单变量分析中，治疗不依从性也与年龄较小和非白人有关。性别与治疗不依从性无显著相关性；药物治疗方案中不良反应的发生也与治疗不依从性无显著相关性。
在研究人群中，酗酒、感染艾滋病毒和不与家庭成员同住是初治肺结核患者不遵医嘱治疗的主要预测因素。
