Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study

Background Poor treatment adherence among leprosy patients contribute to relapse, development of antimicrobial resistance, and the eventual plateauing of the prevalence and incidence of leprosy not just in the Philippines, but also worldwide. For this reason, we aimed to identify the patterns and de...

Full description

Saved in:
Bibliographic Details
Main Authors: Pepito, Veincent Christian F, Amit, Arianna Maever L, Samontina, Rae Erica D, Abdon, Sarah Jane A, Fuentes, David Norman L, Saniel, Ofelia P
Format: text
Published: Archīum Ateneo 2021
Subjects:
Online Access:https://archium.ateneo.edu/asmph-pubs/40
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1046&context=asmph-pubs
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Ateneo De Manila University
id ph-ateneo-arc.asmph-pubs-1046
record_format eprints
spelling ph-ateneo-arc.asmph-pubs-10462022-06-22T10:25:45Z Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study Pepito, Veincent Christian F Amit, Arianna Maever L Samontina, Rae Erica D Abdon, Sarah Jane A Fuentes, David Norman L Saniel, Ofelia P Background Poor treatment adherence among leprosy patients contribute to relapse, development of antimicrobial resistance, and the eventual plateauing of the prevalence and incidence of leprosy not just in the Philippines, but also worldwide. For this reason, we aimed to identify the patterns and determinants affecting treatment completion and default among multibacillary leprosy patients. Methods We conducted a retrospective cohort study involving three large hospitals in Metro Manila, Philippines. Patients who started the World Health Organization - Multiple Drug Therapy for multibacillary leprosy between January 1, 2007 and December 31, 2013 were included in the study. Selected socio-demographic and clinical data were abstracted from the patient treatment records. Survival analysis and proportional hazards regression were used to analyze the data. Results Records of 1,034 patients with a total follow-up time of 12,287 person-months were included in the analysis. Most patients were male, younger than 45 years old, had an initial bacterial index between 1 and 4, and were residents of Metro Manila. Less than 20% had their treatment duration extended to more than 12 months. Treatment adherence of the patients was poor with less than 60% completing treatment. Most patients complete their treatment within 12 months, but treatment duration may be extended for up to three years. Patients who default from treatment usually do so a few months after initiating it. After adjusting for other variables, hospital, initial bacterial index, and non-extended treatment duration were associated with treatment completion. These factors, in addition to age, were also found to be associated with treatment default. Conclusion This study provides quantitative evidence that there might be marked variations in how doctors in particular hospitals manage their patients, and these findings underscore the need to revisit and re-evaluate clinical practice guidelines to improve treatment outcomes and adherence. 2021-06-01T07:00:00Z text application/pdf https://archium.ateneo.edu/asmph-pubs/40 https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1046&context=asmph-pubs Ateneo School of Medicine and Public Health Faculty Publications Archīum Ateneo treatment adherence multibacillary leprosy multiple drug therapy survival analysis cohort study Philippines Immunology and Infectious Disease Public Health
institution Ateneo De Manila University
building Ateneo De Manila University Library
continent Asia
country Philippines
Philippines
content_provider Ateneo De Manila University Library
collection archium.Ateneo Institutional Repository
topic treatment adherence
multibacillary leprosy
multiple drug therapy
survival analysis
cohort study
Philippines
Immunology and Infectious Disease
Public Health
spellingShingle treatment adherence
multibacillary leprosy
multiple drug therapy
survival analysis
cohort study
Philippines
Immunology and Infectious Disease
Public Health
Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
description Background Poor treatment adherence among leprosy patients contribute to relapse, development of antimicrobial resistance, and the eventual plateauing of the prevalence and incidence of leprosy not just in the Philippines, but also worldwide. For this reason, we aimed to identify the patterns and determinants affecting treatment completion and default among multibacillary leprosy patients. Methods We conducted a retrospective cohort study involving three large hospitals in Metro Manila, Philippines. Patients who started the World Health Organization - Multiple Drug Therapy for multibacillary leprosy between January 1, 2007 and December 31, 2013 were included in the study. Selected socio-demographic and clinical data were abstracted from the patient treatment records. Survival analysis and proportional hazards regression were used to analyze the data. Results Records of 1,034 patients with a total follow-up time of 12,287 person-months were included in the analysis. Most patients were male, younger than 45 years old, had an initial bacterial index between 1 and 4, and were residents of Metro Manila. Less than 20% had their treatment duration extended to more than 12 months. Treatment adherence of the patients was poor with less than 60% completing treatment. Most patients complete their treatment within 12 months, but treatment duration may be extended for up to three years. Patients who default from treatment usually do so a few months after initiating it. After adjusting for other variables, hospital, initial bacterial index, and non-extended treatment duration were associated with treatment completion. These factors, in addition to age, were also found to be associated with treatment default. Conclusion This study provides quantitative evidence that there might be marked variations in how doctors in particular hospitals manage their patients, and these findings underscore the need to revisit and re-evaluate clinical practice guidelines to improve treatment outcomes and adherence.
format text
author Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
author_facet Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
author_sort Pepito, Veincent Christian F
title Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
title_short Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
title_full Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
title_fullStr Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
title_full_unstemmed Patterns and Determinants of Treatment Completion and Default Among Newly Diagnosed Multibacillary Leprosy Patients: A Retrospective Cohort Study
title_sort patterns and determinants of treatment completion and default among newly diagnosed multibacillary leprosy patients: a retrospective cohort study
publisher Archīum Ateneo
publishDate 2021
url https://archium.ateneo.edu/asmph-pubs/40
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1046&context=asmph-pubs
_version_ 1736864425196912640