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Selected Works of David Bangsberg
Article
Re-Inventing Adherence: Toward a Patient-Centered Model of Care for Drug-Resistant Tuberculosis and HIV
International Journal of Tuberculosis and Lung Disease
  • Max R. O'Donnell, Columbia University Medical Center
  • A. Daftary, Centre for the AIDS Programme of Research in South Africa
  • M. Frick, Treatment Action Group, New York
  • Y. Hirsch-Moverman, Columbia University - Mailman School of Public Health
  • K. R. Amico, University of Michigan, Ann Arbor
  • M. Senthilingam, University of Cape Town
  • A. Wolf, Columbia University Medical Center
  • J. Z. Metcalfe, University of Cape Town
  • P. Isaakidis, Médecins Sans Frontières, Mumbai
  • J. L. Davis, Yale University School of Public Health
  • J. R. Zelnick, Touro College Graduate School of Social Work
  • J.C.M. Brust, Montefiore Medical Center & Albert Einstein College of Medicine
  • N. Naidu, Centre for the AIDS Programme of Research in South Africa
  • M. Garretson, Columbia University - Mailman School of Public Health
  • David Bangsberg, Portland State University
  • N. Padayatchi, Centre for the AIDS Programme of Research in South Africa
  • G. Friedland, Yale University School of Public Health
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Document Type
Post-Print
Publication Date
4-1-2016
Subjects
  • Multidrug-resistant tuberculosis,
  • Tuberculosis -- Treatment,
  • Patient compliance,
  • Patient-centered health care,
  • HIV infections
Disciplines
Physical Description
8 pages
Abstract

BACKGROUND—Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care.

OBJECTIVE—To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support.

DISCUSSION—Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully implementing team-based patient-centered care, empowering patients through counseling and support, maintaining a rights-based approach while acknowledging the responsibility of health care systems in providing comprehensive care, and prioritizing critical research gaps.

CONCLUSION—It is time to re-invent our understanding of adherence in drug-resistant TB and HIV by focusing attention on the complex clinical, behavioral, social, and structural needs of affected patients and communities.

Description

Author's version of an article that was subsequently published in the International Journal of Tuberculosis and Lung Disease, 2016 April; 20(4): 430-434, published by the International Union Against Tuberculosis and Lung Disease. May be accessed at http://doi.org/10.5588/ijtld.15.0360.

At the time of writing, David Bansberg was affiliated with Harvard Medical School.

DOI
10.5588/ijtld.15.0360
Persistent Identifier
http://archives.pdx.edu/ds/psu/18625
Publisher
International Union Against Tuberculosis and Lung Disease
Citation Information
116. O'Donnell MR, Daftary A, Frick M, Hirsch-Moverman Y, Amico KR, Senthilingam M, Wolf A, Metcalfe JZ, Isaakidis P, Davis JL, Zelnick JR, Brust JC, Naidu N, Garretson M, Bangsberg DR, Padayatchi N, Friedland G; Re-inventing adherence: toward a patient-centered model of care for drug-resistant tuberculosis and HIV. Int J Tuberc Lung Dis; 2016 Apr;20(4):430-4