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Adherence And Tuberculosis Knowledge Among Patients In A Directly Observed Preventive Therapy Program In Harlem
2001 International Conference of the American Thoracic Society, San Francisco, CA. May 2001.

Hirsch-Moverman Y, O'Garro-Humphrey P, Medard F, Nader N, Thomas G, El-Sadr W. Adherence And Tuberculosis Knowledge Among Patients In A Directly Observed Preventive Therapy Program In Harlem.

Introduction: An important strategy in TB control is ensuring completion of treatment of latent TB infection (LTBI), especially among high-risk patients. Directly Observed Preventive Therapy (DOPT) has been used successfully in special populations. Little is known about TB knowledge among patients (pts) beginning DOPT, and the impact of these parameters on adherence (ADH) with treatment.

Methods: We assessed pts demographics, substance use, TB knowledge, and treatment ADH in Harlem "surrogate family" clinic-based DOPT program. The knowledge portion included 24 items on transmission, testing and treatment.

Results: Of 67 patients, 76% were African-American, 15% Latino, 45% foreign-born, mean age of 44 years, 38% had a history of homelessness, 42% had completed high school, 68% had a history of substance use, 27% were currently using illicit drugs and 10% were previously treated for LTBI. At baseline, 67% of patients had known HIV status with 23% HIV positive. Overall, treatment ADH with doses was 96%, with 77% of patients taking >95% of prescribed medications. Of twenty-four questions regarding TB knowledge, 15.2% of patients with ADH>95% and 16.7% of patients with adherence <95% answered correctly 75% or more of questions with mean score of 15.7. Patients had similar TB knowledge scores regardless of ADH or HIV status.

Conclusions: Pts enrolled in the Harlem DOPT Program had exceptionally high treatment adherence in spite of characteristics thought to be associated with non ADH. TB knowledge at baseline was not associated with ADH.