患者和医疗服务提供者对长效结核病预防性治疗的偏好。

Patient and provider preferences for long-acting TB preventive therapy.

作者信息

Vermeulen M, Scarsi K K, Furl R, Sayles H, Anderson M J, Valawalkar S, Kadam A, Cox S R, Mave V, Barthwal M, Schutz C, Ward A, Dountio Ofimboudem J, Meintjes G, Rannard S, Owen A, Swindells S

机构信息

Department of Medicine and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa.

College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

IJTLD Open. 2025 May 12;2(5):276-283. doi: 10.5588/ijtldopen.24.0670. eCollection 2025 May.

DOI:10.5588/ijtldopen.24.0670

PMID:40365033

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12068448/

Abstract

BACKGROUND

Tuberculosis preventive therapy (TPT) is critical for TB elimination but is underutilised. Long-acting (LA) TPT can potentially improve linkage to care, treatment adherence and outcomes.

METHODS

We conducted a cross-sectional in-person survey in two high TB burden countries to evaluate preferences and concerns about LA formulations for TPT. The survey compared oral pills to LA injections, implants, and microarray patches (MAPs). A parallel online survey of healthcare providers (HCPs) in low- and middle-income countries (LMICs) assessed the perceived feasibility of implementation. Data were summarised by descriptive statistics.

RESULTS

We recruited 409 patients (India, = 209; South Africa, = 200) and 94 HCP participants. The mean age of patients was 40 years; 65% were female, and 26% reported a history of TPT. Injectable LA-TPT was the most preferred modality, followed by pills, implants, and then MAPs. The majority (75%) expressed a strong willingness to try injectable LA-TPT. Among providers, 43% favoured injectable LA-TPT, 26% preferred oral pills, 18% implants, and 13% MAPs. Cost was a significant factor influencing HCPs' willingness to adopt LA-TPT, while potential inefficacy and prolonged side effects were the highest concerns of patient respondents.

CONCLUSION

Injectable LA-TPT may be highly acceptable and feasible if concerns surrounding cost, effectiveness, and safety are addressed.

摘要

背景

结核病预防性治疗（TPT）对消除结核病至关重要，但未得到充分利用。长效（LA）TPT有可能改善治疗的衔接、治疗依从性及治疗效果。

方法

我们在两个结核病负担较高的国家进行了一项横断面现场调查，以评估对TPT长效制剂的偏好和担忧。该调查将口服片剂与长效注射剂、植入剂和微阵列贴片（MAPs）进行了比较。对低收入和中等收入国家（LMICs）的医疗服务提供者（HCPs）进行了一项平行在线调查，评估了实施的可行性。数据通过描述性统计进行总结。

结果

我们招募了409名患者（印度，n = 209；南非，n = 200）和94名HCP参与者。患者的平均年龄为40岁；65%为女性，26%报告有TPT病史。长效注射用TPT是最受欢迎的方式，其次是片剂、植入剂，然后是MAPs。大多数（75%）表示非常愿意尝试长效注射用TPT。在医疗服务提供者中，43%倾向于长效注射用TPT，26%更喜欢口服片剂，18%喜欢植入剂，13%喜欢MAPs。成本是影响HCP采用长效TPT意愿的一个重要因素，而潜在的无效性和长期副作用是患者受访者最担心的问题。