How do we measure adherence to anti-tuberculosis treatment?

ABSTRACT

Introduction: Completion of anti-tuberculosis (TB) treatment is of paramount importance for TB patients, as well as for the global efforts of TB control. However, there is neither a gold-standard measure to monitor adherence to TB treatment nor a widely used definition for different levels of adherence.

Areas covered: in this review we aim to describe the different methods used to measure patients’ adherence to anti-TB treatment, identifying their main strengths and limitations, with a focus on low resource settings.

Expert commentary: there is a need for continuing the quest for a low cost, reliable and acceptable measure of adherence to TB treatment. We should harmonize treatment adherence measurement to allow adequate comparison of different interventions aimed at increasing adherence to TB treatment, although the way we ensure adherence can affect adherence endpoints themselves. The accuracy of adherence measurement is of importance in the context of drug clinical development.

KEYWORDS:

• Adherence
• compliance
• tuberculosis
• treatment
• DOTs
• measures

Acknowledgments

We would like to thank Prof. Jimmy Volmink (Stellenbosch University, South Africa) and Dr. Sabine Hermans (Amsterdam Institute for Global Health and Development, AIGHD, The Netherlands) for their expert advice and for reviewing this manuscript. Special thanks to Eduardo Giménez-Cassina for his help in the design of Figure 1.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.