Factors Affecting TB Compliance

In the worldwide fight against tuberculosis, patient non-compliance with treatment protocols affects the success of anti-tuberculosis campaigns and patient health. Numerous studies reported by the National Institutes of Health, BioMed Central and others on non-compliance with tuberculosis treatment in various populations around the world reveal that factors such as expense, knowledge about the disease, and social and economic factors may play a role in patients' refusal to comply with treatment.

Financial Factors

• According to a National Institutes of Health report on treatment non-compliance in Malaysia, the cost and difficulty of travel to and from treatment centers may play a role in discontinuing treatment. Similarly, patients forced to miss work due to treatment may become non-compliant from fear of losing employment. Those seen as the economic mainstay of the family may also be less compliant with the demands of treatment.

Knowledge and Education

• A study reported by the Indian Journal of Community Medicine associates non-compliance with illiteracy, speculating that illiterate patients may not understand the nature of the disease and consequences of failure to comply with treatment. Similarly, a broader study on therapeutic compliance reported by the National Institutes of Health suggests that patients with lower levels of formal education may be less likely to comply with treatment, or to understand the risks associated with refusing treatment.

Social and Cultural Factors

• A National Institutes of Health study on non-compliance in Uzbekistan found that those on the margins of society, such as substance abusers and the homeless, are less likely to comply with treatment. In some cultures, suspicion about the Western-oriented treatment model results in non-compliance, with patients expressing a preference for traditional alternatives. Other cultural issues involve stigmatization of tuberculosis sufferers, or reluctance to go alone to treatment centers.

Significance

• The National Institutes of Health reports on the consequences of non-compliance with tuberculosis treatment emphasize the need to discover and address the factors which contribute to non-compliance, in order to improve treatment outcomes in at-risk populations worldwide, and reduce the threat posed by this disease.