KNCV Tuberculosis Foundation, The Hague, The Netherlands.
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
PLoS One. 2018 Oct 10;13(10):e0205433. doi: 10.1371/journal.pone.0205433. eCollection 2018.
Patient support during tuberculosis treatment is expected to be more often available and more customized in low tuberculosis incidence, high-resource settings than in lower-resource settings. The aim of this systematic review is to provide an overview of tuberculosis patient support interventions implemented in low-incidence countries and an evaluation of their effects on treatment-related outcomes as well as their acceptability by patients and providers.
PubMed, Social Science Citation Index and Cumulative Index to Nursing and Allied Health and Literature were searched for the period 01.2006-05.2016 on publications describing tuberculosis patient support interventions in low-incidence countries (<20 patients per 100,000 population).
Through our search strategy, 1875 unique publications were identified. Forty publications were included: 17 evaluated patient support quantitatively, 9 qualitatively and 14 only described the patient support. Nineteen publications assessed treatment supervision options only, 21 assessed (combinations of) treatment supervision, socio-economic, psycho-emotional, health-educational and other support. Of eight studies quantitatively evaluating the effects of support with a control group, four showed positive effects: two out of three that used combinations of patient support and two out of five that compared treatment supervision options. Heterogeneity of interventions precluded pooling of results. Qualitative and descriptive studies showed that patients appreciated individualized support including treatment supervision, psycho-emotional and socio-economic support; and digital health interventions.
Our review shows that a variety of patient support interventions is implemented in low-incidence countries. Although only a few interventions were evaluated quantitatively, we identified potential best practices. The scarcity of evidence on effectiveness, however, indicates the need for further research to evaluate potential best practices.
在结核病发病率较低、资源较丰富的环境中，患者在治疗期间获得的支持预计会比资源较少的环境中更加频繁和更加个性化。本系统综述的目的是概述在低发病率国家实施的结核病患者支持干预措施，并评估这些干预措施对治疗相关结局的影响，以及患者和提供者对这些干预措施的接受程度。
检索 2006 年 1 月至 2016 年 5 月期间在 PubMed、社会科学引文索引和 Cumulative Index to Nursing and Allied Health 和 Literature 中发表的描述低发病率国家（每 10 万人中<20 例）结核病患者支持干预措施的文献，以获取相关出版物。
通过我们的搜索策略，确定了 1875 个独特的出版物。共纳入 40 篇文献：17 篇定量评估患者支持，9 篇定性评估，14 篇仅描述患者支持。19 篇评估了治疗监督方案，21 篇评估了（组合）治疗监督、社会经济、心理情绪、健康教育和其他支持。在对有对照组的支持效果进行定量评估的 8 项研究中，有 4 项显示出积极的效果：3 项使用患者支持组合的研究中有 2 项，5 项比较治疗监督方案的研究中有 2 项。由于干预措施的异质性，无法对结果进行汇总。定性和描述性研究表明，患者赞赏包括治疗监督、心理情绪和社会经济支持以及数字健康干预在内的个性化支持。
本综述表明，在低发病率国家实施了多种患者支持干预措施。尽管只有少数干预措施进行了定量评估，但我们确定了潜在的最佳实践。然而，关于有效性的证据稀缺表明需要进一步研究来评估潜在的最佳实践。
