A Quantitative Study Of Tuberculosis Preventive Treatment Compliance In Patients With Rheumatic Diseases

Background Implementation of preventive treatment among people with latent tuberculosis infection is an important strategy for the management of tuberculosis.Patients with rheumatic diseases are one of the high risk populations for active tuberculosis.Presently,there are existing consensus in regard of latent tuberculosis infection in patients with rheumatic diseases.However,more researches are needed in terms of patient compliance in real clinical settings.This study aims to discover the barriers to implementing latent tuberculosis infection screening and preventive treatment in patients with rheumatic diseases.Method Convenient sampling was used to include patients at the age of eighteen or older,with rheumatic diseases and who had the indications for latent tuberculosis infection screening and tuberculosis preventive treatment.A questionnaire was distributed to all the participants to investigate their tuberculosis-related knowledge and opinion,their willingness to receive latent tuberculosis infection screening and tuberculosis preventive treatment,the tolerability of pill and time burden,and the preferred way of receiving preventive treatment.SPSS was used to summarize the answer of the questionnaire and to analyze the factors that affect the compliance of latent tuberculosis infection screening and tuberculosis preventive treatment.Result Two hundreds pieces of questionnaires were distributed and collected.35%of participants had a good knowledge of tuberculosis.More than half of the participants believed that patients with rheumatic diseases were faced with a higher risk of tuberculosis than general population.34.5%of participants thought that getting tuberculosis would cause discrimination.One third of participants found it embarrassing if other people know they were taking anti-tuberculosis medication.Participants who believed that patients with rheumatic diseases were more likely to develop tuberculosis scored higher in tuberculosis-related knowledge than those who thought that patients with rheumatic diseases were less likely to develop tuberculosis(4.0 vs.2.0,adjusted P<0.001).75%of participants reported to have no idea about latent tuberculosis infection.82%participants said they were willing to receive latent tuberculosis infection screening if their physician suggested them to do the screening.76.5%participants were willing to take the medication if they had latent tuberculosis infection and if their physician suggested them to take tuberculosis preventive treatment.Believing that tuberculosis was very unlikely to happen was the most common reason for refusing screening.The most common reason for refusing preventive treatment was worrying the side effect of medication.The correlation between participants’ education level and their willingness to receive latent tuberculosis infection screening was statistically significant(Z=-2.484,P=0.013).Being aware of the higher risk of developing tuberculosis in patients with rheumatic diseases was significantly correlated to the willingness of receiving tuberculosis preventive treatment(X2=20.476,P<0.001).A higher percentage of participants who were willing to receive treatment knew the effect of tuberculosis preventive treatment(83.0%vs.0,P<0.001).When the pill burden increased to 6 pills or more per day,more than half of the participants would not be able to tolerate.More than half of the participants could tolerated a regime of 9 month or longer.Most participants preferred to receive tuberculosis preventive treatment at the department of rheumatology.Conclusion Enhancing tuberculosis-related knowledge among patients with rheumatic diseases,explaining the higher risk of developing tuberculosis in those patients and the benefit of preventive treatment might be helpful to increase their compliance of latent tuberculosis infection screening and tuberculosis preventive treatment.Reducing pill burden and adopting latent tuberculosis infection screening and preventive treatment into the routine medical services of rheumatology might be beneficial for tuberculosis management in patients with rheumatic diseases.