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Latent tuberculosis treatment completion rates from prescription drug administrative data.

Authors
  • Plourde, Pierre J1, 2, 3
  • Basham, Christopher A4
  • Derksen, Shelley5
  • Schultz, Jennifer5
  • McCulloch, Scott5
  • Larcombe, Linda6, 7, 8
  • Kinew, Kathi Avery9
  • Lix, Lisa M6, 5
  • 1 Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. [email protected] , (Canada)
  • 2 Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. [email protected] , (Canada)
  • 3 Integrated Tuberculosis Services, Winnipeg Regional Health Authority, 490 Hargrave Street, Winnipeg, Manitoba, R3A 0X7, Canada. [email protected] , (Canada)
  • 4 British Columbia Centre for Disease Control and School of Population and Public Health, University of British Columbia, Vancouver, Canada. , (Canada)
  • 5 Manitoba Centre for Health Policy, Winnipeg, Canada. , (Canada)
  • 6 Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. , (Canada)
  • 7 Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. , (Canada)
  • 8 Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. , (Canada)
  • 9 Nanaandawewigamig, First Nations Health and Social Secretariat of Manitoba, Winnipeg, Canada. , (Canada)
Type
Published Article
Journal
Canadian journal of public health = Revue canadienne de sante publique
Publication Date
Dec 01, 2019
Volume
110
Issue
6
Pages
705–713
Identifiers
DOI: 10.17269/s41997-019-00240-1
PMID: 31297736
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In the province of Manitoba, Canada, given that latent tuberculosis infection (LTBI) treatment is provided at no cost to the patient, treatment completion rates should be optimal. The objective of this study was to estimate LTBI treatment completion using prescription drug administrative data and identify patient characteristics associated with completion. Prescription drug data (1999-2014) were used to identify individuals dispensed isoniazid (INH) or rifampin (RIF) monotherapy. Treatment completion was defined as being dispensed INH for ≥ 180 days (INH180) or ≥ 270 days (INH270) or RIF for ≥ 120 days (RIF120). Logistic regression models tested socio-demographic and comorbidity characteristics associated with treatment completion. The study cohort comprised 4985 (90.4%) persons dispensed INH and 529 (9.6%) RIF. Overall treatment completion was 60.2% and improved from 43.1% in 1999-2003 to 67.3% in 2009-2014. INH180 showed the highest completion (63.8%) versus INH270 (40.4%) and RIF120 (27.0%). INH180 completion was higher among those aged 0-18 years (68.5%) compared with those aged 19+ (61.0%). Sex, geography, First Nations status, income quintile, and comorbidities were not associated with completion. Benchmark 80% treatment completion rates were not achieved in Manitoba. Factors associated with non-completion were older age, INH270, and RIF120. Access to shorter LTBI treatments, such as rifapentine/INH, may improve treatment completion.

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