Toward patient-centered tuberculosis preventive treatment: preferences for regimens and formulations in Lima, Peru

Author:

Yuen Courtney M.,Millones Ana K.,Galea Jerome T.ORCID,Puma Daniela,Jimenez Judith,Lecca Leonid,Becerra Mercedes C.,Keshavjee Salmaan

Abstract

ABSTRACTBackgroundTo ensure patient-centered TB preventive treatment, it is important to consider factors that make it easier for patients to complete treatment. However, there is little published literature about patient preferences for different preventive treatment regimen options, particularly from countries with high tuberculosis burdens.MethodsWe conducted a qualitative research study using a framework analysis approach to understand preventive treatment preferences among household contacts. We conducted three focus group discussions with 16 members of families affected by TB in Lima, Peru. Participants were asked to vote for preferred preventive treatment regimens and discuss the reasons behind their choices. Coding followed a deductive approach based on prior research, with data-driven codes added.ResultsIn total, 7 (44%) participants voted for 3 months isoniazid and rifapentine, 4 (25%) chose 3 months isoniazid and rifampicin, 3 (19%) chose 4 months rifampicin, and 2 (13%) chose 6 months isoniazid. Preferences for shorter regimens over 6 months of isoniazid were driven by concerns over “getting tired” or “getting bored” of taking medications, the difficulty of remembering to take medications, side effects, and interference with daily life. For some, weekly dosing was perceived as being easier to remember and less disruptive, leading to a preference for 3 months isoniazid and rifapentine, which is dosed weekly. However, among caregivers, having a child-friendly formulation was more important than regimen duration. Caregivers reported difficulty in administering pills to children, and preferred treatments available as syrup or dispersible formulations.ConclusionsThere is demand for shorter regimens and child-friendly formulations for preventive treatment in a high-burden setting. Individual preferences differ, suggesting that patient-centered care would best be supported by having multiple shorter regimens available.

Publisher

Cold Spring Harbor Laboratory

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