COMPARATIVE ANALYSIS OF APPLICATION OF THE MORISKY-GREEN SCALE AND THE QUESTIONNAIRE "COMPLIANCE LEVEL" IN THE STUDY OF ADHERENCE TO TREATMENT IN PATIENTS WITH PULMONARY TUBERCULOSIS
1Scientific Research Institute of Public Health and Health Organization, Tashkent, Republic of Uzbekistan
2Department of Phthisiology, Tashkent Pediatric Medical Institute, Tashkent, Republic of Uzbekistan
Objective: To study the level of compliance in patients with pulmonary tuberculosis and selection of the most optimal questionnaire for routine screening of adherence to treatment, both at the hospital and primary health care level.
Methods: The study conducted for 70 patients with an established diagnosis of pulmonary tuberculosis (sensitive form). Two questionnaires were chosen as the methods for the study of compliance: the Morisky-Green scale and the "Compliance level" questionnaire. These patients were interviewed on the above questionnaires, the results of which were compared among themselves.
Results: Based on the results of the study, we obtained discordant results: on the Morisky-Green scale, the number of adherents was 18.6%, and according to the questionnaire "Compliance level», 78.6% of patients showed a high level of compliance. Discordant results can be explained by distrust to each other, both from the patient and from the attending physician. So, as in a personal conversation with each patient are directed on the clarification of reasons for the discrepancy of results the overwhelming majority of the respondents have answered that they wanted to wish and make a positive impression on the attending physician.
Conclusions: In patients with pulmonary tuberculosis, there is a fear of stigmatization in relation to them from the society that negatively affects the relationship of the attending physician and the patient. Because the selected questionnaires refer to an indirect method of diagnosing compliance and depend on the conscientiousness of the examinee, it is necessary to exert all efforts establish a cooperation between the attending physician and the patient.
Keywords: Compliance, patients with pulmonary tuberculosis, treatment, questionnaires, therapeutic cooperation.
- Ubaydullaev AM, Absadykova FT, Tashpulatova FK. Tuberkulyoz v Uzbekistane [Tuberculosis in Uzbekistan]. Tuberkulyoz i bolezni lyogkikh. 2011;11:10-4.
- Danilov DS. Terapevticheskoe sotrudnichestvo (komplaens): soderzhanie ponyatiya, mekhanizmy formirovaniya i metody optimizatsii [Ther-apeutic cooperation (compliance): concept content, formation mechanisms and optimisation methods]. Nevrologiya, neyropsikhiatriya, psikhosomatika. 2014;2:4-12.
- DiMatteo MR. Variations in patients' adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200-9.
- Simons VS, Roth S, Jaehde U. Therapietreue dauerhaft verbessern. Pharmazeutische Zeitung. 2007;47:16-23.
- Volskaya EA. Patsientskiy komplaens. Obzor tendentsiy v issledovaniyakh [Patient compliance. Overview of research trends]. Remedium. 2013;11:6-15.
- El Malla H, Helm NY, Wilderäng U, El Sayed Elborai Y, Steineck G, Kreicbergs U. Adherence to medication: A nation-wide study from the Children's Cancer Hospital, Egypt. World J Psychiatry. 2013;3(2):25-33. Available from: http://dx.doi.org/10.5498/wjp.v3.i2.25.
- Haskard Zolnierek KB, DiMatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826-34. Available from: http://dx.doi.org/10.1097/MLR.0b013e31819a5acc.
- McCabe R, Khanom H, Bailey P, Priebe S. Shared decision-making in ongoing outpatient psychiatric treatment. Patient Educ Couns. 2013; 91(3):326-8. Available from: http://dx.doi.org/10.1016/j.pec.2012.12.020.
- Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011;168(6):603-9. Available from: http://dx.doi.org/10.1176/appi.ajp.2011.10081224.
- Fusar-Poli P, Kempton M, Rosenheck RA. Efficacy and safety of second-generation long-acting injections in schizophrenia: a meta-analysis of randomized-controlled trials. Int Clin Psychopharmacol. 2013;28(2):57-66. Available from: http://dx.doi.org/10.1097/YIC.0b013e32835b091f.
- Kardas P. Patient compliance with antibiotic treatment for respiratory tract infections. J Antimicrob Chemother. 2002;49(6):897-903.
- Kadyrov RV, Asriyan OB, Kovalchuk S.A. Oprosnik «Uroven' komplaentnosti» [The Questionnaire “Level of Compliance”]. Vladivostok, RF: Mor. gos. un-t; 2014. 74 p.
- Dalaryu VV, Yudin SA., Borzenko AS. Komplaentnost' bol'nykh tuberkulyozom lits (po dannym komparativnogo analiza) [Compliance of tuberculosis patients (based on the comparative analysis)]. Elektronnyy zhurnal Meditsinskaya psikhologiya v Rossii. 2013;4(21). Available from: http://mprj.ru.
Khomova Natalia Aleksandrovna, Junior Researcher, Department of Health Economics and Finance, Scientific Research Institute of Public Health and Health Organization
Tashpulatova Fatima Kudratovna, Doctor of Medical Sciences, Associate Professor, Head of the Department of Phthisiology, Tashkent Pediatric Medical Institute
Address for correspondence:
Khomova Natalia Aleksandrovna
Junior Researcher, Department of Health Economics and Finance, Scientific Research Institute of Public Health and Health Organization
100140, Republic of Uzbekistan, Tashkent, Boghishamol str., 223
Tel.: (+998) 946 189413
Materials on the topic:
- STIGMA AND DISCRIMINATION ASSOCIATED WITH TUBERCULOSIS
- IMPROVEMENT RESULTS OF DIAGNOSIS AND TREATMENT OF ABDOMINAL TUBERCULOSIS
- ABDOMINAL TUBERCULOSIS: RETURN TO SURGERY
- DYNAMICS OF THE INDICATORS OF LUNG DESTRUCTION AND HORMONAL BACKGROUND AS A PREDICTIVE MARKER OF THE EFFECTIVENESS OF MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT
- EFFICACY OF TUBERCULOSIS CASES DETECTION AMONG THE POPULATION OF DUSHANBE IN THE REPUBLIC OF TAJIKISTAN
- ULTRASOUND DIAGNOSTICS OF ABDOMINAL TUBERCULOSIS IN THE CONDITIONS OF THE OUTPATIENT-DIAGNOSTIC DEPARTMENT
- THE FREQUENCY OF DEVELOPMENT OF TUBERCULOSIS AMONG CITIZENS OF THE REPUBLIC OF TAJIKISTAN, LEAVING TO LABOR MIGRATION
- THE ROLE OF THE IMPLANTABLE PORT SYSTEM FOR THE CENTRAL VENOUS ACCESS IN TREATMENT OF PULMONARY TUBERCULOSIS WITH MULTIPLE AND EXTENSIVELY DRUG RESISTANCE (PRELIMINARY RESULTS)
- SURGICAL TREATMENT OF PULMONARY AND EXTRAPULMONARY TUBERCULOSIS
- THE INFLUENCE OF BCG VACCINATION ON THE STRUCTURE OF CLINICAL FORMS OF TUBERCULOSIS IN CHILDREN FROM THE FOCI OF INFECTION AND FROM UNSPECIFIED CONTACT FOR TUBERCULOSIS