Viegas Ana Maria, Miranda Silvana Spíndola de, Haddad João Paulo, Ceccato Maria das Graças, Carvalho Wânia da Silva
Universidade Federal de Minas Gerais, Faculdade de Farmácia, Pós-Graduação em Medicamentos e Assistência Farmacêutica, Belo Horizonte, Minas Gerais, Brazil.
Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, Minas Gerais, Brazil.
Rev Inst Med Trop Sao Paulo. 2017 Jun 1;59:e28. doi: 10.1590/S1678-9946201759028.
The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72.3% - 60/ 83). When a greater number of medicines was used, the chance of noncompliance with treatment increased exponentially (p = 0.00 - OR 1.72). Light-skinned black patients, alcoholics and those who live with HIV/ AIDS showed a significant association with noncompliance with treatment (p=0.039 - OR 3.38, p=0.002 - OR 4.68, and p=0.001 - OR 9.68, respectively). Comprehension also presented a significant association with noncompliance with treatment (p=0.01 and OR 5.76 and CI 1.49-22.29). The probability of noncompliance with treatment in the first few months was greater than in the subsequent months. This study demonstrates that if the TB patients had a better understanding of the treatment, the outcome would have been more favorable as regards a proper cure.
本研究旨在评估巴西米纳斯吉拉斯州孔塔任市采用固定剂量复合制剂（FDC）治疗的结核病患者的治疗效果与理解能力、依从性及行为特征之间的关联。本研究使用标准化问卷收集数据。治疗结果包括77.2%（64/83）的治愈率、20.4%（17/83）的治疗不依从率，以及无器官衰竭或死亡病例。治疗依从率较高（71.1% - 59/83），而大多数患者对治疗的理解水平不足（72.3% - 60/83）。使用的药物数量越多，治疗不依从的几率呈指数级增加（p = 0.00 - 比值比1.72）。浅肤色黑人患者、酗酒者以及感染艾滋病毒/艾滋病者与治疗不依从存在显著关联（p = 0.039 - 比值比3.38，p = 0.002 - 比值比4.68，以及p = 0.001 - 比值比9.68）。理解能力与治疗不依从也存在显著关联（p = 0.01，比值比5.76，置信区间1.49 - 22.29）。最初几个月治疗不依从的概率高于随后几个月。本研究表明，如果结核病患者对治疗有更好的理解，在实现恰当治愈方面结果会更有利。
