Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines
Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines. We examined the influence of individual and site characteristics on the concordance between prescribed treatment regimens and recommended standardized...
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| Veröffentlicht in: | PloS one 2018-11, Vol.13 (11), p.e0203749-e0203749 |
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| creator | van de Water, Brittney J Silva, Susan G Prvu Bettger, Janet Humphreys, Janice Cunningham, Coleen K Farley, Jason E |
| description | Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines.
We examined the influence of individual and site characteristics on the concordance between prescribed treatment regimens and recommended standardized regimen according to national guidelines for patients with drug-resistant tuberculosis (DR-TB) in South Africa.
Participants were 337 youth and adults treated for DR-TB between November 2014 and August 2016 at ten DR-TB treatment sites in Eastern Cape and KwaZulu Natal provinces, South Africa. Logistic regression was used to determine individual and system characteristics related to concordance at treatment initiation between the prescribed treatment regimens in terms of medication composition, dosage, and frequency and guideline-based standardized regimen that included four oral and one injectable medications.
The sample was 19% (n = 64) youth (15-24 years), 53% (n = 179) male, 73% (n = 243) HIV coinfected, and 51% (n = 169) with prior history of TB treatment. Guideline medications were correctly prescribed for 88% (n = 295) of patients, but only 33% (n = 103) received the correct medications and doses. Complete guideline adherence to medications, doses, and frequency was achieved for 30% (n = 95) of patients. Younger age, HIV coinfection, and rural treatment setting were associated with the prescription of correct medications.
Most individuals are prescribed the correct DR-TB medications, yet few individuals receive correct medications, dosages, and frequencies. Further study is needed to examine the root causes for treatment guideline deviations and opportunities for improvement. |
| doi_str_mv | 10.1371/journal.pone.0203749 |
| format | Article |
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We examined the influence of individual and site characteristics on the concordance between prescribed treatment regimens and recommended standardized regimen according to national guidelines for patients with drug-resistant tuberculosis (DR-TB) in South Africa.
Participants were 337 youth and adults treated for DR-TB between November 2014 and August 2016 at ten DR-TB treatment sites in Eastern Cape and KwaZulu Natal provinces, South Africa. Logistic regression was used to determine individual and system characteristics related to concordance at treatment initiation between the prescribed treatment regimens in terms of medication composition, dosage, and frequency and guideline-based standardized regimen that included four oral and one injectable medications.
The sample was 19% (n = 64) youth (15-24 years), 53% (n = 179) male, 73% (n = 243) HIV coinfected, and 51% (n = 169) with prior history of TB treatment. Guideline medications were correctly prescribed for 88% (n = 295) of patients, but only 33% (n = 103) received the correct medications and doses. Complete guideline adherence to medications, doses, and frequency was achieved for 30% (n = 95) of patients. Younger age, HIV coinfection, and rural treatment setting were associated with the prescription of correct medications.
Most individuals are prescribed the correct DR-TB medications, yet few individuals receive correct medications, dosages, and frequencies. Further study is needed to examine the root causes for treatment guideline deviations and opportunities for improvement.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0203749</identifier><identifier>PMID: 30395565</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Adults ; Age Factors ; Analysis ; Biology and Life Sciences ; Care and treatment ; Case management ; Coinfection - drug therapy ; Coinfection - epidemiology ; Direct reduction ; Drug resistance ; Drug resistance in microorganisms ; Female ; Guideline Adherence ; Guidelines ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV-1 ; Human immunodeficiency virus ; Humans ; Male ; Medical ethics ; Medicine and Health Sciences ; Middle Aged ; Multidrug resistant organisms ; Nursing schools ; Patients ; People and places ; Practice guidelines (Medicine) ; Practice Guidelines as Topic ; Review boards ; Risk Factors ; Rural Population ; South Africa - epidemiology ; Studies ; Systematic review ; Tuberculosis ; Tuberculosis, Multidrug-Resistant - drug therapy ; Tuberculosis, Multidrug-Resistant - epidemiology ; Youth</subject><ispartof>PloS one, 2018-11, Vol.13 (11), p.e0203749-e0203749</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 van de Water et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 van de Water et al 2018 van de Water et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-d76ac8eaf988dc46044da583cc4f32db1ae3fafb1e405d7c6ab8014867d0d18b3</citedby><cites>FETCH-LOGICAL-c692t-d76ac8eaf988dc46044da583cc4f32db1ae3fafb1e405d7c6ab8014867d0d18b3</cites><orcidid>0000-0002-0476-6295</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218024/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218024/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30395565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van de Water, Brittney J</creatorcontrib><creatorcontrib>Silva, Susan G</creatorcontrib><creatorcontrib>Prvu Bettger, Janet</creatorcontrib><creatorcontrib>Humphreys, Janice</creatorcontrib><creatorcontrib>Cunningham, Coleen K</creatorcontrib><creatorcontrib>Farley, Jason E</creatorcontrib><title>Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines.
We examined the influence of individual and site characteristics on the concordance between prescribed treatment regimens and recommended standardized regimen according to national guidelines for patients with drug-resistant tuberculosis (DR-TB) in South Africa.
Participants were 337 youth and adults treated for DR-TB between November 2014 and August 2016 at ten DR-TB treatment sites in Eastern Cape and KwaZulu Natal provinces, South Africa. Logistic regression was used to determine individual and system characteristics related to concordance at treatment initiation between the prescribed treatment regimens in terms of medication composition, dosage, and frequency and guideline-based standardized regimen that included four oral and one injectable medications.
The sample was 19% (n = 64) youth (15-24 years), 53% (n = 179) male, 73% (n = 243) HIV coinfected, and 51% (n = 169) with prior history of TB treatment. Guideline medications were correctly prescribed for 88% (n = 295) of patients, but only 33% (n = 103) received the correct medications and doses. Complete guideline adherence to medications, doses, and frequency was achieved for 30% (n = 95) of patients. Younger age, HIV coinfection, and rural treatment setting were associated with the prescription of correct medications.
Most individuals are prescribed the correct DR-TB medications, yet few individuals receive correct medications, dosages, and frequencies. Further study is needed to examine the root causes for treatment guideline deviations and opportunities for improvement.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Age Factors</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Case management</subject><subject>Coinfection - drug therapy</subject><subject>Coinfection - epidemiology</subject><subject>Direct reduction</subject><subject>Drug resistance</subject><subject>Drug resistance in microorganisms</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Guidelines</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medical ethics</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multidrug resistant organisms</subject><subject>Nursing schools</subject><subject>Patients</subject><subject>People and places</subject><subject>Practice guidelines (Medicine)</subject><subject>Practice Guidelines as Topic</subject><subject>Review boards</subject><subject>Risk Factors</subject><subject>Rural Population</subject><subject>South Africa - epidemiology</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Tuberculosis, Multidrug-Resistant - epidemiology</subject><subject>Youth</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk81u1DAQxyMEoqXwBggsISE47GLHjpNwQKoqPipVKqLA1ZrYk6yrrL3YzgLvwQPjZbeli3rAOXgy-c1_MmNPUTxmdM54zV5d-ik4GOcr73BOS8pr0d4pDlnLy5nMr3dv2AfFgxgvKa14I-X94oBT3laVrA6LXx-DX9tovSO-J8NkDY7W4ayDiIZoCEh6H4gJ0zALGG1M4BJJU4dBT6PPDmIdufBTWpDjPlgNr8kZrnHcyGnvtA8GnEbSYfqO6Mgqq-hgO-uGbINOVmMk4Mzf5PFhca-HMeKj3X5UfHn39vPJh9nZ-fvTk-OzmZZtmWamlqAbhL5tGqOFpEIYqBquteh5aToGyHvoO4aCVqbWErqGMtHI2lDDmo4fFU-3uqtcido1NKqS8dwqxvM6Kk63hPFwqVbBLiH8VB6s-uPwYVAQcgkjKtFJU3air6joRV2XUJc5RyuhNdiCrrLWm122qVui0ehSgHFPdP-Lsws1-LWSWYiWIgu82AkE_23CmNTSRo3jCA79tP1vTlnLyow--we9vbodNUAuwLre57x6I6qOK8lYI4WsMzW_hcqPwaXNR4y9zf69gJd7AZlJ-CMNMMWoTi8-_T97_nWffX6DXSCMaRH9OKV8e-M-KLagDj7GgP11kxlVm-G56obaDI_aDU8Oe3LzgK6DrqaF_wap5RfB</recordid><startdate>20181105</startdate><enddate>20181105</enddate><creator>van de Water, Brittney J</creator><creator>Silva, Susan G</creator><creator>Prvu Bettger, Janet</creator><creator>Humphreys, Janice</creator><creator>Cunningham, Coleen K</creator><creator>Farley, Jason E</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0476-6295</orcidid></search><sort><creationdate>20181105</creationdate><title>Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines</title><author>van de Water, Brittney J ; Silva, Susan G ; Prvu Bettger, Janet ; Humphreys, Janice ; Cunningham, Coleen K ; Farley, Jason E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-d76ac8eaf988dc46044da583cc4f32db1ae3fafb1e405d7c6ab8014867d0d18b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Age Factors</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Case management</topic><topic>Coinfection - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van de Water, Brittney J</au><au>Silva, Susan G</au><au>Prvu Bettger, Janet</au><au>Humphreys, Janice</au><au>Cunningham, Coleen K</au><au>Farley, Jason E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-11-05</date><risdate>2018</risdate><volume>13</volume><issue>11</issue><spage>e0203749</spage><epage>e0203749</epage><pages>e0203749-e0203749</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines.
We examined the influence of individual and site characteristics on the concordance between prescribed treatment regimens and recommended standardized regimen according to national guidelines for patients with drug-resistant tuberculosis (DR-TB) in South Africa.
Participants were 337 youth and adults treated for DR-TB between November 2014 and August 2016 at ten DR-TB treatment sites in Eastern Cape and KwaZulu Natal provinces, South Africa. Logistic regression was used to determine individual and system characteristics related to concordance at treatment initiation between the prescribed treatment regimens in terms of medication composition, dosage, and frequency and guideline-based standardized regimen that included four oral and one injectable medications.
The sample was 19% (n = 64) youth (15-24 years), 53% (n = 179) male, 73% (n = 243) HIV coinfected, and 51% (n = 169) with prior history of TB treatment. Guideline medications were correctly prescribed for 88% (n = 295) of patients, but only 33% (n = 103) received the correct medications and doses. Complete guideline adherence to medications, doses, and frequency was achieved for 30% (n = 95) of patients. Younger age, HIV coinfection, and rural treatment setting were associated with the prescription of correct medications.
Most individuals are prescribed the correct DR-TB medications, yet few individuals receive correct medications, dosages, and frequencies. Further study is needed to examine the root causes for treatment guideline deviations and opportunities for improvement.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30395565</pmid><doi>10.1371/journal.pone.0203749</doi><tpages>e0203749</tpages><orcidid>https://orcid.org/0000-0002-0476-6295</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Adults Age Factors Analysis Biology and Life Sciences Care and treatment Case management Coinfection - drug therapy Coinfection - epidemiology Direct reduction Drug resistance Drug resistance in microorganisms Female Guideline Adherence Guidelines HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV-1 Human immunodeficiency virus Humans Male Medical ethics Medicine and Health Sciences Middle Aged Multidrug resistant organisms Nursing schools Patients People and places Practice guidelines (Medicine) Practice Guidelines as Topic Review boards Risk Factors Rural Population South Africa - epidemiology Studies Systematic review Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Youth |
| title | Provision of guideline-based care for drug-resistant tuberculosis in South Africa: Level of concordance between prescribing practices and guidelines |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T23%3A19%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Provision%20of%20guideline-based%20care%20for%20drug-resistant%20tuberculosis%20in%20South%20Africa:%20Level%20of%20concordance%20between%20prescribing%20practices%20and%20guidelines&rft.jtitle=PloS%20one&rft.au=van%20de%20Water,%20Brittney%20J&rft.date=2018-11-05&rft.volume=13&rft.issue=11&rft.spage=e0203749&rft.epage=e0203749&rft.pages=e0203749-e0203749&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0203749&rft_dat=%3Cgale_plos_%3EA561186467%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2130051333&rft_id=info:pmid/30395565&rft_galeid=A561186467&rft_doaj_id=oai_doaj_org_article_4b6d2b4f504f4772a7218b96a9de9ac5&rfr_iscdi=true |