Project Title: Study of Factors Associated with Acceptance of, Adherence to, and Toxicity from Treatment for Latent Tuberculosis Infection: Phase 3 - Prospective Cohort Study of Acceptance and Adherence

Co-Principal Investigator(s): Robin Shrestha-Kuwahara, MPH1, Robert Horsburgh, MD2, Stefan Goldberg, MD1

Project Dates: 2005-2009

Project Overview: As one of the TB Epidemiologic Studies Consortium (TBESC) research studies, this project aims to understand the scope of treatment of latent tuberculosis infection (LTBI) in the United States and Canada and to elucidate factors associated with acceptance and completion of treatment. Phase 3 of the study is a prospective cohort study of approximately 2,400 adult patients 18 years and older who have been offered treatment for LTBI in the United States and Canada. Twelve TBESC sites and associated local clinics are participating in Phase 3. Taking an ecological approach, this study addresses a wide range of factors, including knowledge, attitudes, and beliefs, as well as toxicity, tolerability, social and economic factors, and issues associated with clinic structures and the health care delivery system. The interviews will be administered at the time treatment is offered and, for those who initiate, again at the time participants drop out of or complete treatment. A randomized sample of this cohort will receive brief, periodic follow-up interviews at designated intervals. Enrollment will continue over a 12-month period.

Objectives: The primary objectives of the study are to identify potentially modifiable factors associated with acceptance or nonacceptance of LTBI treatment, and to identify potentially modifiable factors related to completion or noncompletion of treatment.

Target Audience: Persons offered treatment for LTBI in the United States and Canada

Methods: Phase 3 will collect information through the following methods and sources: 1) an initial interview administered to persons offered treatment for LTBI to assess the factors affecting patients' decision and ability to initiate and complete treatment and to identify potentially modifiable factors related to acceptance and completion of treatment; 2) an exit interview administered at the time of treatment cessation or completion; 3) follow-up interviews at periodic intervals for persons randomized to this arm; 4) chart abstractions; and 5) a clinic survey to describe the local context and LTBI treatment protocols.

Results: Project is in progress

Contact Information:
Robin Shrestha-Kuwahara, MPH
Behavioral Scientist
Centers for Disease Control and Prevention
Division of Tuberculosis Elimination
1600 Clifton Road, NE, Mailstop E-10
Atlanta, GA 30333

Relative Content:

1 Division of Tuberculosis Elimination, Centers for Disease Control and Prevention
2 Boston University