Abstract
Objective: To clarify factors influencing the maintenance and promotion of oral medication adherence in initial, continuation, and completion phases among older patients with tuberculosis at home who follow a regional directly observed treatment short-course (DOTS) for all treatment phases.
Methods: Semi-structured interviews were conducted with 10 patients aged 65 years or older who had followed a regional DOTS for all treatment phases. The data were qualitatively and descriptively analyzed with reference to Berelson’s content analysis for each phase.
Results: In the initial phase, the factors included “determination to take oral medication for early recovery,” ”a way to help take and manage oral medication suited to oneself,” and “the building of relationships through interactions with doctors, nurses and other healthcare professionals.” In the continuation phase, the factors included “realization of the significance of continuing to take oral medication through the experience of taking medication” and “positive feedback and coordination by doctors and nurses to promote continuation of oral medication.” In the completion phase, the factors were “firming determination to take oral medication enhanced by the imminent completion of oral medication” and “support from doctors, nurses, and other healthcare professionals with a mutually forward-looking attitude toward the completion of oral medication.”
Discussion: Support for older patients with tuberculosis at home needs to enable maintenance and promotion of oral medication adherence using approaches tailored to the characteristics of phase-specific factors, including building trusting relationships, explaining the effects of oral medication, providing feedback, and adopting a cooperative attitude toward completion of treatment.
