مقاله انگلیسی الگوها و تعیین کننده های تکمیل درمان و پیش فرض در بیماران جذام
ترجمه نشده

مقاله انگلیسی الگوها و تعیین کننده های تکمیل درمان و پیش فرض در بیماران جذام

عنوان فارسی مقاله: الگوها و تعیین کننده های تکمیل درمان و پیش فرض در بیماران جذام چند عاملی که اخیراً تشخیص داده شده اند: یک مطالعه کوهورت گذشته نگر
عنوان انگلیسی مقاله: Patterns and determinants of treatment completion and default among newly diagnosed multibacillary leprosy patients: A retrospective cohort study
مجله/کنفرانس: هلیون - Heliyon
رشته های تحصیلی مرتبط: پزشکی، داروسازی
گرایش های تحصیلی مرتبط: بهداشت عمومی، داروشناسی
کلمات کلیدی فارسی: تبعیت از درمان ، جذام چند دردی ، درمان دارویی متعدد ، تجزیه و تحلیل بقا ، مطالعه کوهورت ، فیلیپین
کلمات کلیدی انگلیسی: Treatment adherence, Multibacillary leprosy, Multiple drug therapy, Survival analysis, Cohort study, Philippines
نوع نگارش مقاله: مقاله پژوهشی (Research Article)
شناسه دیجیتال (DOI): https://doi.org/10.1016/j.heliyon.2021.e07279
دانشگاه: University of the Philippines Manila, Philippines
صفحات مقاله انگلیسی: 8
ناشر: الزویر - Elsevier
نوع ارائه مقاله: ژورنال
نوع مقاله: ISI
سال انتشار مقاله: 2021
ایمپکت فاکتور: 2.850 در سال 2020
شاخص H_index: 28 در سال 2021
شاخص SJR: 0.455 در سال 2020
شناسه ISSN: 2405-8440
شاخص Quartile (چارک): Q1 در سال 2020
فرمت مقاله انگلیسی: PDF
وضعیت ترجمه: ترجمه نشده است
قیمت مقاله انگلیسی: رایگان
آیا این مقاله بیس است: بله
آیا این مقاله مدل مفهومی دارد: دارد
آیا این مقاله پرسشنامه دارد: ندارد
آیا این مقاله متغیر دارد: ندارد
کد محصول: E15470
رفرنس: دارای رفرنس در داخل متن و انتهای مقاله
نوع رفرنس دهی: vancouver
فهرست مطالب (انگلیسی)

Abstract

Keywords

Introduction

Methods

Results

Discussion

Conclusions

Other information

Declarations

Acknowledgements

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بخشی از مقاله (انگلیسی)

Abstract

Background
Poor treatment adherence among leprosy patients contribute to relapse, development of antimicrobial resistance, and the eventual plateauing of the prevalence and incidence of leprosy not just in the Philippines, but also worldwide. For this reason, we aimed to identify the patterns and determinants affecting treatment completion and default among multibacillary leprosy patients.

Methods
We conducted a retrospective cohort study involving three large hospitals in Metro Manila, Philippines. Patients who started the World Health Organization - Multiple Drug Therapy for multibacillary leprosy between January 1, 2007 and December 31, 2013 were included in the study. Selected socio-demographic and clinical data were abstracted from the patient treatment records. Survival analysis and proportional hazards regression were used to analyze the data.

Results
Records of 1,034 patients with a total follow-up time of 12,287 person-months were included in the analysis. Most patients were male, younger than 45 years old, had an initial bacterial index between 1 and 4, and were residents of Metro Manila. Less than 20% had their treatment duration extended to more than 12 months. Treatment adherence of the patients was poor with less than 60% completing treatment. Most patients complete their treatment within 12 months, but treatment duration may be extended for up to three years. Patients who default from treatment usually do so a few months after initiating it. After adjusting for other variables, hospital, initial bacterial index, and non-extended treatment duration were associated with treatment completion. These factors, in addition to age, were also found to be associated with treatment default.

Conclusion
This study provides quantitative evidence that there might be marked variations in how doctors in particular hospitals manage their patients, and these findings underscore the need to revisit and re-evaluate clinical practice guidelines to improve treatment outcomes and adherence

 

1. Introduction

Poor treatment adherence among leprosy patients is associated with relapse and the occurrence of antimicrobial resistance [[1]]. It has also been reported to contribute to the plateauing incidence and prevalence of leprosy in the Philippines [[2]], and worldwide [[3], [4], [5], [6]]. A perceived reason for poor treatment adherence is the long duration of the World Health Organization (WHO) multiple drug therapy (MDT) regimen, lasting a year for multibacillary leprosy patients [[7], [8]], which could even be extended for up to three years [[9], [10]]. In addition to the long duration of treatment, a host of psychosocial, economic, medical and health service, as well as personal factors were found to affect treatment adherence [[11]]. Two earlier reviews reported the following factors to be associated with poor treatment adherence: socio-economic status; educational attainment; gender; alcohol consumption; knowledge about leprosy; stigma associated with the disease; cultural factors; transportation costs; remoteness of residence; financial concerns; adverse effects of MDT; source of MDT; MDT drug shortages; poor relationship between patient and healthcare provider; and occurrence of leprosy reactions [[1], [12]]