Educational outreach to patients with drug-resistant tuberculosis and its impact on adherence to anti-tuberculosis therapy

The aim was to evaluate the impact of information and educational work with patients with multidrug-resistant tuberculosis (TB) in a tuberculosis hospital on adherence to anti-TB therapy.
Methods. The study included 95 patients, divided into groups based on their participation in the «Tuberculosis Patient School»: 45 patients (who were receiving treatment before the school’s implementation) were not trained; 50 patients (who were trained). The groups were compared based on length of hospital stay, reasons for early discharge, and level of treatment adherence.
Results. High treatment adherence during the inpatient stage was noted in both study groups (p=0.08). Non-participants of the «School of Tuberculosis Patients» (group 1, treated before the school’s implementation) were more often discharged from the hospital early (OR=2.7, 95% CI 1.1-6.7). The frequency of missing 6-11% of doses of anti-tuberculosis drugs was higher in the first group (OR = 4.1, 95% CI 1.5-11.1), and 5% or less doses – in the second (OR=0.3, 95% CI 0.1-0.8).
Conclusion. The lack of informational work led to an increase in early discharge, which was more often associated with unauthorized withdrawal from the department. The findings indicate an increase in patient adherence to treatment during informational and educational work, which was reflected in a decrease in the frequency of short-term interruptions in treatment (OR = 4.1).

1. Бутина А.В., Кузуб О.С. Основания коммуникации врача и пациента в условиях цифровизации //Пробл. социал. гигиены, здравоохранения и истории медицины. – 2023. – Т. 31. – № 2. – С. 195-200.

2. Глобальный доклад по борьбе с туберкулезом, 2024. URL: https://apps.who.int/iris/bitstream/handle/10665/337538/9789240017009-rus.pdf

3. Наумов А.Г., Шпрыков А.С., Долгова М.А., Фомина Н.В. Использование аддитивных технологий с целью повышения приверженности лечению, увеличения эффективности химиотерапии и коррекции показателей тревоги и депрессии среди больных деструктивным туберкулезом легких // Consilium Medicum. – 2024. – Т. 26. – № 3. – С. 199-207.doi 10.26442/20751753.2024.3.202743

4. Отраслевые и экономические показатели противотуберкулезной работы в 2022–2023 гг. / И.А. Васильева, С.А. Стерликов, ВВ. Тестов [и др.]. – М.: НМИЦ ФПИ, 2024. – 59 с.

5. Павлюченкова Н.А., Васильева И.А., Самойлова А.Г., Тюлькова Т.Е. Видеоконтролируемое лечение – инновационный метод мониторинга терапии туберкулеза в условиях ограниченных ресурсов системы здравоохранения // Туберкулез и болезни легких. – 2022. – Т. 100. – № 2. – С. 53-60. http://doi.org/10.21292/2075-1230-2022-100-2-53-6

6. Пьянзова Т.В., Вежнина Н.Н. Мероприятия по повышению приверженности лечению больных туберкулезом в Российской Федерации // Медицина в Кузбассе. – 2014. – № 3. – С. 5-10.

7. Хомова Н.А. и др. Роль школы больного туберкулезом легких в создании терапевтического альянса между лечащим врачом и пациентом с целью формирования приверженности к лечению // Вестн. Центр.НИИ туберкулеза. – 2018. – №. 4. – С. 68-74.

8. Azizi N.,Karimy M.,Salahshour V.N. Determinants of adherence to tuberculosis treatment in Iranian patients: Application of health belief mode // JIDC. – 2018. -№ 12. –P. 706-711.

9. Guix-Comellas E.M., Rozas-Quesada L., Morín-Fraile V. et al. Educational measure for promoting adherence to treatment for tuberculosis // Procedia Soc.Behav. Sci. – 2017. – Vol. 237. – P. 705-709.

10. Perriot J., Masson M., Peiffer G. Renforcer l’éducation thérapeutique des patients tuberculeux [Strengthening therapeutic education for tuberculosis patients] // Rev. Infirm. – 2025. – Vol. 74, №316. – P. 41-43. doi: 10.1016/j.revinf.2025.10.031.

11. Tola H.H., Shojaeizadeh D., Tol A. et al. Psychological and educational intervention to improve tuberculosis treatment adherence in Ethiopia based on health belief model: A cluster randomized control trial // PLoS ONE. – 2016. – №11. – P. 1-15. 10.1371/journal.pone.0155147.

12. Yousif K. et al. The effect of an educational intervention on awareness of various aspects of pulmonary tuberculosis in patients with the disease // Eastern Mediter. Health J. – 2021. – Т. 27. – № 3