Patient satisfaction and adherence to tuberculosis treatment among adults in the National Tuberculosis Program-Uganda: a cross sectional study.

BACKGROUND

Non-adherence is a complex challenge to global tuberculosis control because it arises from the interaction of multiple factors, and yet, there are few studies that have evaluated beyond patient factors into the organization and processes of tuberculosis service delivery. We examined the relationship between patient satisfaction and adherence among adult TB patients.

METHODS

In a cross-sectional study, we hypothesized that patients with high satisfaction scores were more likely to adhere to prescribed tuberculosis treatment than patients with lower satisfaction scores. 469 new TB cases aged 18 years and older were consecutively recruited from the National TB & Leprosy program-Uganda. The outcome variable was adherence (high was ≥90% Morisky scores) to TB treatment. The exposure variable was patient satisfaction (PS) scores.

RESULTS

Of the 469 patients, 29% (135/469) were non adherent). Patients satisfaction scores on the responsiveness to patients' preferences were higher among the adherent compared to the non-adherent, 62.1 ± 8.8 versus 63.8 ± 7.3 (p=0.014), respectively. Patients were very satisfied with the technical quality of care and management of patient's preferences, and were least satisfied with the amount of information about action usage, and effects of tuberculosis medication, regardless of adherence levels. For every unit increase in patient satisfaction scoes for the clinic structure, there was an associated decrease in the level of non-adherence.

CONCLUSION

Patients' satisfaction with the organization and processes of the clinic was associated with non-adherence to tuberculosis medication. The satisfaction scores for information about action usage, and effects of tuberculosis medication were low.