Re-inventing adherence: Toward a patient-centered model of care for drug-resistant tuberculosis and HIV

M. R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J. C.M. Brust, N. Naidu, M. Garretson, D. R. Bangsberg, N. Padayatchi, G. Friedland

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

BACKGROUND: Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care. OBJECTIVE : To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support. DISCUS S ION: Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TBHIV could be improved by fully implementing teambased patient-centered care, empowering patients through counseling and support, maintaining a rightsbased approach while acknowledging the responsibility of health care systems in providing comprehensive care, and prioritizing critical research gaps. CONCLUS ION: It is time to re-invent our understanding of adherence in drug-resistant TB and HIV by focusing attention on the complex clinical, behavioral, social, and structural needs of affected patients and communities.

Original languageEnglish (US)
Pages (from-to)430-434
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2016

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Keywords

  • Drug-resistant TB
  • HIV
  • Medication adherence
  • Patient-centered care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

O'Donnell, M. R., Daftary, A., Frick, M., Hirsch-Moverman, Y., Amico, K. R., Senthilingam, M., Wolf, A., Metcalfe, J. Z., Isaakidis, P., Davis, J. L., Zelnick, J. R., Brust, J. C. M., Naidu, N., Garretson, M., Bangsberg, D. R., Padayatchi, N., & Friedland, G. (2016). Re-inventing adherence: Toward a patient-centered model of care for drug-resistant tuberculosis and HIV. International Journal of Tuberculosis and Lung Disease, 20(4), 430-434. https://doi.org/10.5588/ijtld.15.0360