Treatment default among urban tuberculosis patients, Thailand

Tuberculosis treatment default, missing medical appointments for two consecutive months or more, is a serious problem not only for individuals but also for societies and health-care systems. Most research focuses only on patient factors without considering health-care system factors' effects on treatment default. The study purpose was to examine the influence of process of care on treatment default. Structured interviews and medical chart reviews were conducted in 160 tuberculosis patients receiving care at a tertiary hospital in Thailand. The samples included 54 patients with treatment default and 106 patients with treatment completion. Hierarchical logistic regression was used to examine relationships among the variables. After adjusting for patient factors, having severe medication side-effect and travel time to clinic increased treatment default. The patient factor of being paid on a daily basis was also significantly associated with treatment default. Evidence indicates that some process of care factors influence treatment default. Findings can be applied to practice levels to maintain patients until treatment completion.