基于处方药物管理数据的潜伏性肺结核治疗完成率。
Latent tuberculosis treatment completion rates from prescription drug administrative data.
机构信息
Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
出版信息
Can J Public Health. 2019 Dec;110(6):705-713. doi: 10.17269/s41997-019-00240-1. Epub 2019 Jul 11.
OBJECTIVE
In the province of Manitoba, Canada, given that latent tuberculosis infection (LTBI) treatment is provided at no cost to the patient, treatment completion rates should be optimal. The objective of this study was to estimate LTBI treatment completion using prescription drug administrative data and identify patient characteristics associated with completion.
METHODS
Prescription drug data (1999-2014) were used to identify individuals dispensed isoniazid (INH) or rifampin (RIF) monotherapy. Treatment completion was defined as being dispensed INH for ≥ 180 days (INH180) or ≥ 270 days (INH270) or RIF for ≥ 120 days (RIF120). Logistic regression models tested socio-demographic and comorbidity characteristics associated with treatment completion.
RESULTS
The study cohort comprised 4985 (90.4%) persons dispensed INH and 529 (9.6%) RIF. Overall treatment completion was 60.2% and improved from 43.1% in 1999-2003 to 67.3% in 2009-2014. INH180 showed the highest completion (63.8%) versus INH270 (40.4%) and RIF120 (27.0%). INH180 completion was higher among those aged 0-18 years (68.5%) compared with those aged 19+ (61.0%). Sex, geography, First Nations status, income quintile, and comorbidities were not associated with completion.
CONCLUSIONS
Benchmark 80% treatment completion rates were not achieved in Manitoba. Factors associated with non-completion were older age, INH270, and RIF120. Access to shorter LTBI treatments, such as rifapentine/INH, may improve treatment completion.
目的
在加拿大马尼托巴省，由于潜伏性结核感染（LTBI）的治疗对患者免费，因此治疗完成率应该是最佳的。本研究的目的是使用处方药管理数据来估计 LTBI 的治疗完成率，并确定与完成治疗相关的患者特征。
方法
使用处方药数据（1999-2014 年）来确定接受异烟肼（INH）或利福平（RIF）单药治疗的个体。治疗完成定义为接受 INH 治疗≥180 天（INH180）或≥270 天（INH270）或 RIF 治疗≥120 天（RIF120）。逻辑回归模型测试了与治疗完成相关的社会人口统计学和合并症特征。
结果
研究队列包括 4985 名（90.4%）接受 INH 治疗和 529 名（9.6%）接受 RIF 治疗的患者。总体治疗完成率为 60.2%，从 1999-2003 年的 43.1%提高到 2009-2014 年的 67.3%。INH180 的完成率最高（63.8%），其次是 INH270（40.4%）和 RIF120（27.0%）。0-18 岁患者的 INH180 完成率（68.5%）高于 19 岁以上患者（61.0%）。性别、地理位置、第一民族身份、收入五分位数和合并症与完成情况无关。
结论
马尼托巴省未达到 80%的治疗完成率基准。与未完成治疗相关的因素包括年龄较大、INH270 和 RIF120。获得更短的 LTBI 治疗，如利福平/INH，可能会提高治疗完成率。
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