Selected Factors that Influence Nonadherence to Antituberculosis Drug Regimen among Tuberculosis Patients at Two (2) Rural Clinics in Guyana, South America
Bhuwandai Gharbaran
College of Medical Sciences, School of Pharmacy, University of Guyana, Turkeyen Campus, Georgetown, Guyana.
Falana Daly
College of Medical Sciences, School of Pharmacy, University of Guyana, Turkeyen Campus, Georgetown, Guyana.
Viannie Ferreira
College of Medical Sciences, School of Pharmacy, University of Guyana, Turkeyen Campus, Georgetown, Guyana.
Jewel Edmondson-Carter
College of Medical Sciences, School of Pharmacy, University of Guyana, Turkeyen Campus, Georgetown, Guyana.
Cecil Boston *
College of Medical Science, School of Allied Health, University of Guyana, Turkeyen Campus, Georgetown, Guyana.
Andrew Hutson *
College of Medical Sciences, School of Medicine, University of Guyana, Turkeyen, Georgetown, Guyana.
*Author to whom correspondence should be addressed.
Abstract
Objectives: This study aimed to identify and compare the factors influencing non-adherence to antituberculosis drug regimens at two rural clinics in Guyana.
Methods: A quantitative, cross-sectional design was employed to examine adherence barriers among tuberculosis (TB) patients at two rural clinics in Guyana. Data were collected using structured questionnaires administered to 46 non-adherent TB patients (15 from Clinic 1 and 31 from Clinic 2). Inclusion criteria and informed consent were adhered to, and a translator facilitated interviews in the Indigenous community served by Clinic 1. Descriptive and comparative statistical analyses were performed to interpret the data.
Results: A total of 46 participants were identified as non-adherent to tuberculosis (TB) treatment protocols were included in the study, with a mean age of 43.7 years for Clinic 1 and 46.3 years for Clinic 2. Among the participants, 32% originated from Clinic 1 and 68% from Clinic 2.
Statistical Analysis: Statistical analysis revealed significant factors influencing non-adherence to treatment. This included knowledge of TB transmission and the quality of patient-provider relationships (p = 0.049), frequency of chest clinic visits (p = 0.015), adherence to prescribed medication regimens (p = 0.001), depression among patients (p = 0.005), clinic attendance patterns, and instances of missed medication doses (p = 0.013). These findings underscore the multifactorial nature of non-adherence in the study population, highlighting both psychosocial and systemic influences.
Conclusion: The findings highlight the interplay of psychological distress, clinic attendance, and patient-provider relationships in influencing TB treatment adherence. Despite high knowledge levels about TB transmission, adherence was limited. Integrated strategies, including mental health interventions, improved patient-provider communication, and logistical support, are essential to enhance adherence and treatment outcomes in rural populations.
Keywords: Tuberculosis, non-adherent, antituberculosis drug regimen, indigenous