Korean J Adult Nurs.  2018 Oct;30(5):493-503. 10.7475/kjan.2018.30.5.493.

Factors Related to Medication Adherence in Adult Patients with Tuberculosis

• Jung EY
• Hwang SK

• KMID: 2423840
• DOI: http://doi.org/10.7475/kjan.2018.30.5.493

Abstract

PURPOSE
This study aimed to explore medication adherence and its related factors, stigma, self-efficacy, and sense of coherence in patients with tuberculosis.
METHODS
A cross-sectional survey was conducted with a convenience sample of 130 adult outpatients with tuberculosis at a university hospital in Busan during from May 1 to August 21, 2017. The data were collected using structured questionnaires comprising research instruments measuring medication adherence, stigma, self-efficacy, and sense of coherence and face-to-face interviews and medical records for treatment delays and participant characteristics. The SPSS/WIN 22.0 program for descriptive statistics, Pearson's correlation coefficients and stepwise multiple regression were used to analyze the data.
RESULTS
The mean score for medication adherence was 4.86±1.48. The factors related to medication adherence in adult outpatients with tuberculosis were stigma (β=−.23, p=.004), self-efficacy (β=.20, p=.036), perceived family support (β=.19, p=.012), and alcohol (β=−.19, p=.021), which explained 38.9% of the variance in medication adherence.
CONCLUSION
The study results suggest that a nursing intervention must be designed to reduce stigma, improve self-efficacy, promote family support, and stop alcohol consumption in order to enhance the medication adherence in adult patients with tuberculosis. Efforts need to educate and encourage tuberculosis patients to adhere strictly to their drugs and conduct various campaigns against the negative perception of tuberculosis.

MeSH Terms

Adult*
Alcohol Drinking
Busan
Cross-Sectional Studies
Humans
Medical Records
Medication Adherence*
Nursing
Outpatients
Self Efficacy
Sense of Coherence
Social Stigma
Tuberculosis*

Reference

1. World Health Organization. Global tuberculosis report 2017 [Internet]. Geneva: WHO;2017. cited 2018 June 25. Avaliable from: http://www.who.int/tb/publications/global_report/en/.

2. Korea Centers for Disease Control & Prevention. Annual report on the notified tuberculosis in Korea, 2016 [internet]. Chungju: Korea Centers for Disease Control & Prevention;2016. cited 2017 August 20. Avaliable from: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME006-MNU3003-MNU2950-MNU2951&cid=75620.

3. Muture BN, Keraka MN, Kimuu PK, Kabiru EW, Ombeka VO, Oguya F. Factors associated with default from treatment among tuberculosis patients in Nairobi province, Kenya: a case control study. BMC Public Health. 2011; 11:696. DOI: 10.1186/1471-2458-11-696.

4. M'Imunya JM, Kredo T, Volmink J. Patient education and counselling for promoting adherence to treatment for tuberculosis. Cochrane Database Syst Rev. 2012; (5):CD006591. DOI: 10.1002/14651858.cd006591.pub2.

5. Woith WM, Larson JL. Delay in seeking treatment and adherence to tuberculosis medications in Russia: a survey of patients from two clinics. Int J Nurs Stud. 2008; 45(8):1163–1174. DOI: 10.1016/j.ijnurstu.2007.07.014.

6. Castlenuovo B. A review of compliance to anti tuberculosis treatment and risk factors for defaulting treatment in Sub Saharan Africa. Afr Health Sci. 2010; 10(4):320–324.

7. Bagchi S, Ambe G, Sathiakumar N. Determinants of poor adherence to anti-tuberculosis treatment in Mumbai, India. Int J Prev Med. 2010; 1(4):223–232.

8. Joo AR. The study of factors influencing medication compliance for pulmonary tuberculosis patients. Seoyeong Univ Reg Dev Inst. 2014; 20:88–104.

9. Park JS. Symptoms and factors associated with delayed diagnosis of pulmonary tuberculosis. Korean J Med. 2013; 84(2):221–228. DOI: 10.3904/kjm.2013.84.2.221.

10. Storla DG, Yimer S, Bjune GA. A systemic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008; 8:15. DOI: 10.1186/1471-2458-8-15.

11. Pungrassami P, Kipp AM, Stewart PW, Chongsuvivatwong V, Strauss RP, Van Rie A. Tuberculosis and AIDS stigma among patients who delay seeking care for tuberculosis symptoms. Int J Tuberc Lung Dis. 2010; 14(2):181–187.

12. Yoo S, Shin H, Roh H, Jo S. A study on the stigma and the intention of disclosure of tuberculosis: focused on health beliefs factors, emotion and knowledge's effect and age group comparison. Advert Res. 2014; 103:214–262.

13. Jung YJ, Kim JH. A study on the relationship between self efficacy and self care behavior in patients with pulmonary tuberculosis. J Korea Community Health Nurs Acad Soc. 1996; 10(2):90–102.

14. Naghib S, Abed Saeedi J, Ezzati Z, Zayeri F. Self-efficacy and compliance with treatment regimen in tuberculosis. Adv Nurs Midwifery. 2012; 22(77):Available from: http://journals.sbmu.ac.ir/en-jnm/article/view/4099.

15. Seong YS, Lee YW. Relationship of illness perception, self-efficacy, and self-care among pulmonary tuberculosis patients. Korean J Adult Nurs. 2011; 23(1):31–39.

16. Antonovsky A. Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass;1987.

17. Nabi H, Vahtera J, Singh-Manoux A, Pentti J, Oksanen T, Gimeno D, et al. Do psychological attributes matter for adherence to antihypertensive medication? the Finnish public sector cohort study. J Hypertens. 2008; 26(11):2236–2243. DOI: 10.1097/HJH.0b013e32830dfe5f.

18. Park SJ, An M, So HS. Relationships of stigma, family support, and quality of life in tuberculosis patients. J Korea Contents Assoc. 2015; 15(9):285–294. DOI: 10.5392/JKCA.2015.15.09.285.

19. Takarinda KC, Harries AD, Nyathi B, Ngwenya M, Mutasa-Apollo T, Sandy C. Tuberculosis treatment delays and associated factors within the Zimbabwe national tuberculosis programme. BMC Public Health. 2015; 15:29. DOI: 10.1186/s12889-015-1437-7.

20. Van Rie A, Sengupta S, Pungrassami P, Balthip Q, Choonuan S, Kasetjaroen Y, et al. Measuring stigma associated with tuberculosis and HIV/AIDS in southern Thailand: exploratory and confirmatory factor analyses of two new scales. Trop Med Int Health. 2008; 13(1):21–30. DOI: 10.1111/j.1365-3156.2007.01971.x.

21. Chen G, Gully SM, Eden D. Validation of a new general selfefficacy scale. Organ Res Method. 2001; 4(1):62–83. DOI: 10.1177/109442810141004.

22. Suh SR, Lee EH. A path model predicting medication adherence and self-care of low-income older adults with hypertension. Korean J Adult Nurs. 2011; 23(4):374–385.

23. Kim KS, Choi-Kwon S, Han K. Structural equation modeling on health status in hospital nurses: based on the theory of salutogenesis with bio behavioral approach. J Korean Biol Nurs Sci. 2015; 17(1):50–59. DOI: 10.7586/jkbns.2015.17.1.50.

24. Eriksson M, Lindström B. Validity of Antonovsky's sense of coherence scale: a systematic review. J Epidemiol Community Health. 2005; 59(6):460–466. DOI: 10.1136/jech.2003.018085.

25. Bae SG, Jeon HJ, Yang HS, Kim BK, Park KS. Medication adherence and its predictors in community elderly patients with hypertension. Korean J Health Promot. 2015; 15(3):121–128. DOI: 10.15384/kjhp.2015.15.3.121.

26. Chu SH, Ko IS, Lee WH, Yoo JS, Kang SM, Jung HY, et al. Factors affecting medication adherence in patients with chronic heart failure. J Korean Biol Nurs Sci. 2012; 14(3):193–202. DOI: 10.7586/jkbns.2012.14.3.193.

27. Montgomery DC, Peck EA, Vining GG. Introduction to linear regression analysis. 5th ed. New Jersey: Wiley;2012. p. 285–326.

28. Zeller A, Ramseier E, Teagtmeyer A, Battegay E. Patients' selfreported adherence to cardiovascular medication using electronic monitors as comparators. Hypertens Res. 2008; 31(11):2037–2043. DOI: 10.1291/hypres.31.2037.

29. Shiotani R, Hennink M. Socio-cultural influences on adherence to tuberculosis treatment in rural India. Glob Public Health. 2014; 9(10):1239–1251. DOI: 10.1080/17441692.2014.953562.

30. Min SH, Kim JI. Construction of explanatory model for medication adherence in older people with chronic disease. J Korean Acad Fundam Nurs. 2012; 19(4):463–473. DOI: 10.7739/jkafn.2012.19.4.463.

31. Munro AA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med. 2007; 4(7):e238. DOI: 10.1371/journal.pmed.0040238.