Xie Lantian, Chen Yan, Zhang Lifan, Zhao Lidan, Li Tao, Shi Xiaochun, Liu Xiaoqing
Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Infect Drug Resist. 2024 Aug 7;17:3403-3414. doi: 10.2147/IDR.S471448. eCollection 2024.
Tuberculosis preventive treatment (TPT) is an important strategy for tuberculosis (TB) control. Rheumatic diseases (RD) patients are at high risk for active TB development. More researches are needed in terms of patient compliance in clinical practice. This study aims to explore the potential difficulties and obstacles in latent tuberculosis infection (LTBI) screening and TPT in RD patients.
Convenience sampling was used to recruit RD outpatients who had indications for LTBI screening and TPT. All participants were given questionnaires on knowledge and attitudes regarding screening and preventive treatment of LTBI.
Of the 200 RD patients, most people were aware that they were at increased risk of ATB due to their rheumatic disease and knew that TB was curable. The main association with willingness to have screening for LTBI was tertiary education ( = 0.013). The main association with willingness to take treatment for LTBI was a sense of personal risk and belief that the treatment would reduce risk of ATB ( < 0.001). More than half of the people surveyed could not accept taking 6 or more pills per day, while more than half of the patients could tolerate a treatment course of 9 months or longer. Most (65.4%) preferred their own rheumatologists to initiate treatment.
Educating RD patients about their individual risks of TB and the side effects of treatment, and educating/empowering rheumatologists to discuss these aspects with their patients and to offer LTBI screening and treatment, may help improve patients' compliance with LTBI screening and TPT.
结核病预防性治疗（TPT）是结核病（TB）控制的一项重要策略。风湿性疾病（RD）患者发生活动性结核病的风险很高。在临床实践中，关于患者依从性还需要更多研究。本研究旨在探讨风湿性疾病患者潜伏性结核感染（LTBI）筛查和TPT中潜在的困难和障碍。
采用便利抽样法招募有LTBI筛查和TPT指征的RD门诊患者。所有参与者都收到了关于LTBI筛查和预防性治疗的知识及态度问卷。
在200例RD患者中，大多数人意识到由于自身的风湿性疾病，他们患活动性结核病的风险增加，并且知道结核病是可治愈的。与LTBI筛查意愿的主要关联因素是高等教育（P = 0.013）。与LTBI治疗意愿的主要关联因素是个人风险意识以及相信该治疗会降低活动性结核病的风险（P < 0.001）。超过一半的受访者不能接受每天服用6片或更多片药，而超过一半的患者能够耐受9个月或更长时间的疗程。大多数（65.4%）患者更希望由自己的风湿病医生开始治疗。
对RD患者进行关于其个体结核病风险和治疗副作用的教育，以及对风湿病医生进行教育/授权，使其能够与患者讨论这些方面并提供LTBI筛查和治疗，可能有助于提高患者对LTBI筛查和TPT的依从性。
