A Patient Education Program to Improve Adherence Rates with Antituberculosis Drug Regimens

The design, logic, and results of a two-year health education study directed at im proving rates of patient adherence to antituberculosis medical regimens are presented. An incentive scheme to reward positive health behaviors plus targeted educational coun seling sessions was implemented in a randomized clinical controlled trial. The 205 subjects who participated in the study are categorized according to patients with active tuberculosis ( n = 88) or preventive patients with no evidence of active disease ( n = 117). Patients in each of these groups were randomly assigned to a special intervention (SI) group or a usual care (UC) control group and were followed monthly throughout their treatment program. While SI patients with active tuberculosis demonstrated higher levels of ap pointment-keeping behavior and mean percent of medication taken compared to UC patients, no statistically significant differences between the two groups were found. Pre ventive therapy patients assigned to the SI group, however, were significantly more likely than UC patients to remain in care during their 12-month regimen (64% vs 47%; p = .003). Furthermore, SI patients had significantly higher levels of adherence to their medical regimen compared to UC patients (68% vs 38%; p < .001). These results demonstrate the positive effects of a structured health education program on the im provement of continuity of care and adherence behavior among patients with tuberculosis. This study was funded by the Centers for Disease Control through contract #200-85-0835. The assistance of the Project Clerk, Sook Hee Treadwell, the Project Health Educators, Magda Fischer, Jennifer Adams, Nancy Murray, Fred Dominguez, and the clinic staff and patients who participated in this project are gratefully acknowledged. 1. US Department of Health and Human Services, Public Health Service: The 1990 Health Objectives for the Nation: A Midcourse Review. 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