Factors Contributing to Medication Noncompliance of Newly Diagnosed Smear-Positive Pulmonary Tuberculosis Patients in the District of Colombo, Sri Lanka

Abstract

Medication noncompliance hinders effective tuberculosis control. This descriptive study investigates the factors contributing to medication noncompliance among new patients with smear-positive pulmonary tuberculosis on treatment at government health institutions in Colombo, Sri Lanka. In a cohort of patients aged > or =15 years (n = 326), 23% were found to be noncompliers (n = 74) on follow-up. The median age of noncompliers (50 years) was significantly higher than the compliers (45 years). In multivariate logistic regression analysis, factors associated with noncompliance are as follows: being a male, living alone or with extended family, experiencing side effects to medication, perceiving nonsusceptibility to adverse effects of illness, and perceiving no benefit in regular treatment. The participants of a focus group discussion on service factors opined that the reception at treatment facilities and the interaction with certain categories of staff were poor. Noncompliance is related to a multiplicity of factors involving patients and healthcare services.