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Craig, G. M.; Zumla, A. (2015)
Publisher: Elsevier
Journal: International Journal of Infectious Diseases
Languages: English
Types: Article
Subjects: Social determinants, RC, Stigma, RC109-216, Homeless persons, HM, Adherence, Infectious Diseases, Tuberculosis, Infectious and parasitic diseases, Microbiology (medical), Drug users
Objectives: There is scant qualitative research into the experiences of tuberculosis (TB) treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalized groups attending a major TB centre in London. Methods: A qualitative cross-sectional study was performed using semi-structured interviews with patients receiving treatment for TB. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results: There were 17 participants; the majority were homeless and had complex medical and social needs, including drug and alcohol use or immigration problems affecting entitlement to social welfare. Participants rarely actively chose not to take their medication, but described a number of social and institutional barriers to adherence and their need for practical support. Many struggled with the physical aspects of taking medication and the side effects. Participants receiving directly observed therapy (DOT) reported both positive and negative experiences, reflecting the type of DOT provider and culture of the organization. Conclusions: There is a need for integrated care across drug, alcohol, HIV, and homeless services in order to address the complex clinical co-morbidities and social needs that impact on the patient's ability to sustain a course of treatment.
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    • 1. de Vries G, Aldridge RW, CaylĂ  JA, Haas WH, Sandgren A, van Hest NA, Abubakar I, the Tuberculosis in European Union Big Cities Work: Epidemiology of tuberculosis in big cities of the European Union and European Economic Area countries. Euro Surveill. 2014;19(9):pii=20726.
    • 2. Public Health England: Tuberculosis in the UK: 2014 report. London: HMS Government.
    • 3. Story A., Murad S., Roberts W., Verheyen M, Hayward A.C. and the London Tuberculosis Nurses Network: Tuberculosis in London: the importance of homelessness, problem drug use and prison. Thorax, 2007, 62(8): 667-71.
    • 4. Dheda K, Shean K, Zumla A, Badri M, Streicher EM, Page-Shipp L, Willcox P, John MA, Reubenson G, Govindasamy D, Wong M, Padanilam X, Dziwiecki A, van Helden PD, Siwendu S, Jarand J, Menezes CN, Burns A, Victor T, Warren R, Grobusch MP, van der Walt M, Kvasnovsky C. Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet. 2010 May 22;375(9728):1798-807.
    • 5. Furniss D, Barber N, I Lyons I, Eliasson L, Blandford A. BMJ Qual Saf 2014;23:95- 98. doi:10.1136/bmjqs-2013-002276
    • 6. Farmer, P: Social Inequalities and Emerging Infectious Diseases, Emerging Infectious Diseases 1996 2(4) 259-69
    • 7. Farmer, P: Social Scientists and the new tuberculosis. Soc. Sci. Med.1997, 44 (3):347- 358
    • 8. Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med 2007 Jul 24;4(7):e238.
    • 9. Noyes J, Popay J. Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative metasynthesis. J Adv Nurs 2007 Feb;57(3):227-243.
    • 10. Commission on Social Determinants of Health: Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health: Final Report. 2008. Geneva, Switzerland: World Health Organization
    • 11. Wilkinson R., Marmot M: The Social Determinants of Health. The Solid Facts. 2004. Geneva: WHO. Available http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf. Accessed 30- 04-14
    • 12. Berben L, Dobbels F, Engberg S, Hill MN, De Geest S. An ecological perspective on medication adherence. West J Nurs Res 2012 Aug;34(5):635-653.
    • 13. Craig, G. M., Joly, L. & Zumla, A. 'Complex' but coping: experience of symptoms of tuberculosis and health care seeking behaviours - a qualitative interview study of urban risk groups, London, UK. BMC Public Health, 2014, 14(618), doi: 10.1186/1471-2458-14-618
    • 14. Craig, G.M., Booth, H., Story, A., Hayward, A., Hall, J., Goodburn, A. And Zumla, A: The impact of social factors on tuberculosis management. Journal of Advanced Nursing, 2007, 58(5): 418-424
    • 15. Abrams, L S: Sampling Hard to Reach Populations in Qualitative research: The Case of Incarcerated Youth. Qualitative Social Work, 2010, 9:536-550
    • 16. Miles, MB. Huberman, AM: Qualitative data analysis. 1994. London:Sage
    • 17. Craig, G.M., Booth, H., Hall, J., Story, A., Hayward, A., Goodburn, A. And Zumla, A: Establishing a new service role in tuberculosis care: the tuberculosis link worker. Journal of Advanced Nursing, 2008, 61(4): 413-424.
    • 18. Hepworth, J: The Emergence of Critical Health Psychology, Can it contribute to promoting public health. J Health Psychol 2006, 11: 331 DOI: 10.1177/1359105306063298
    • 19. Braun, V, Clarke, V: (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 2006 3, (2): 77-101
    • 20. Farmer P, Connors M, Simmons J: Women, Poverty & AIDS: Sex, Drugs and Structural Violence Series in Health and Social Justice. 1996. Common Courage Press
    • 21. Scambler, G Re-framing Stigma: Felt and Enacted Stigma and Challenges to the Sociology of Chronic and Disabling Conditions Social Theory & Health, 2004 2, 1, 29-46
    • 22. Liamputtong P, Haritavorn N. To tell or not to tell: disclosure to children and family amongst Thai women living with HIV/AIDS. Health Promot Int. 2014 Jul 17. pii: dau057 (Epub ahead of print]
    • 23 NICE (2007) Community-Based Interventions to Reduce Substance Misuse Among Vulnerable and Disadvantaged Children and Young People. Public Health Intervention Guidance 4. London:NICE
    • 24. Curtis R, Friedman SR, Neaigus A, Jose B, Goldstein M, Des Jarlais DC. Implications of directly observed therapy in tuberculosis control measures among IDUs. Public Health Rep 1994 May-Jun;109(3):319-327
    • 25. Van Hout, MC. Bingham, T. A qualitative study of prescribing doctor experiences of methadone maintenance treatment. Int J Ment Health Addiction (2014) 12:227-242
    • 26. Chesney, M, Ickovics, JR, Chambers, DB, Gifford, AL, Neidig, J, Zwickl, B et al. 2000.`Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG Adherence Instruments', AIDS Care 12(3) (June)
    • 27. Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, et al. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med 2005 Jul;61(1):133-155.
    • 28. Deiss RG, Rodwell TC, Garfein RS. Tuberculosis and illicit drug use: review and update. Clin Infect Dis 2009 Jan 1;48(1):72-82.
    • 29. Sumartojo E. When tuberculosis treatment fails: a social behavioural account of patient adherence. American Review of Respiratory Diseases 1993;147:1311-20.
    • 30. DiMatteo, MR. Social support and patient adherence to medical treatment: a metaanalysis Health Psychology 2004 23(2): 207-18
    • 31. Haynes RB, Ackloo E, Sahota N., et al Interventions for enhancing medication adherence. Cochrane Database Syst Rev 2008;2..CD000011.pub3
    • 32. Rhodes, T. Transition and the HIV risk environment BMJ 2005; 331, 220 doi: http://dx.doi.org/10.1136/bmj.331.7510.220
    • 33 Grenfell P,Baptista Leite R,Garfein R,de Lussigny S,Platt L,Rhodes T. Tuberculosis, injecting drug use and integrated HIV-TB care: a review of the literature Drug Alcohol Depend.2013 May 1;129(3):180-209. doi: 10.1016/j.
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