A randomized, controlled trial of interventions to improve adherence to isoniazid therapy to prevent tuberculosis in injection drug users
A randomized, controlled trial of interventions to improve adherence to isoniazid therapy to prevent tuberculosis in injection drug users
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DOI：
10.1016/s0002-9343(01)00695-7
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发表时间：
2001-06-01
影响因子：
5.9
通讯作者：
Moore, RD
中科院分区：
文献类型：
--
作者：
Chaisson, RE;Barnes, GL;Moore, RD
目得：为了确定几种干预措施对坚持结核病预防性therapeutic.METHODS：我们进行了一项随机试验与析因设计比较策略，以提高坚持异烟肼预防性治疗的300名注射吸毒者与反应性结核菌素试验，没有证据表明活动性结核病。观察组（99例）每周2次直接观察异烟肼预防性治疗，对照组（101例）每天自我服药并进行同伴咨询和教育，常规组（100例）给予常规治疗。每组中的患者也被随机分配接受立即或推迟每月S10津贴，以维持依从性。该试验的终点是完成6个月的治疗，服用药丸测量的自我报告或观察，异烟肼代谢产物存在于尿液中，并通过电子监视器在patients.Results的子集确定开瓶：完成治疗是80%的患者在监督组，78%在同行组，79%在常规组（P = 0.70）。在接受即时激励的患者中，完成率为83%（125/150），而在接受延迟激励的患者中，完成率为75%（112/150）（P = 0.09）。在研究的监督组中，观察到或报告服用至少80%剂量的患者比例为82%，而同伴组为71%，常规组为90%。在监督组中，服用100%剂量的患者比例为77（通过观察），6%的同行组（通过报告），10%的常规组（通过报告; P
PURPOSE: To determine the effect of several interventions on adherence to tuberculosis preventive therapy.METHODS: We conducted a randomized trial with a factorial design comparing strategies for improving adherence to isoniazid preventive therapy in 300 injection drug users with reactive tuberculin tests and no evidence of active tuberculosis. Patients were assigned to receive directly observed isoniazid preventive therapy twice weekly (Supervised group, n = 99), daily self-administered isoniazid with peer counseling and education (Peer group, n = 101), or routine care (Routine group, n = 100). Patients within each arm were also randomly assigned to receive an immediate or deferred monthly S10 stipend for maintaining adherence. The endpoints of the trial were completing 6 months of treatment, pill-taking as measured by self-report or observation, isoniazid metabolites present in urine, and bottle opening as determined by electronic monitors in a subset of patients.RESULTS: Completion of therapy was 80% for patients in the Supervised group, 78% in the Peer group, and 79% in the Routine group (P = 0.70). Completion was 83% (125 of 150) among patients receiving immediate incentives versus 75% (112 of 150) among patients with deferred incentives (P = 0.09). The proportion of patients who were observed or reported taking at least 80% of their doses was 82% for the Supervised arm of the study, compared with 71% for the Peer arm and 90% for the Routine arm. The proportion of patients who took 100% of doses was 77% for the Supervised arm (by observation), 6% for the Peer arm (by report), and 10% for the Routine arm (by report; P