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Tuberculosis

New Insights into Tuberculosis Treatment Adherence Patterns

Strategic Insights

— 1 min read

Researchers have identified four distinct adherence patterns among patients treated for rifampicin- or multidrug-resistant tuberculosis (RR/MDR-TB), contradicting the traditional notion that sustained high adherence is necessary for treatment success. By analyzing data from the endTB observational study, a joint latent class mixed model was applied to classify adherence trajectories and assess their relationship with treatment outcomes. The findings suggest that adherence patterns, rather than overall adherence rates, may be more predictive of clinical outcomes in the management of RR/MDR-TB.

Key Takeaways:

  • The traditional 80% adherence threshold may overlook meaningful patterns in treatment adherence.
  • Four distinct adherence patterns were identified: "consistently high" (72.5%), "high to low" (14.3%), "low to high" (7.3%), and "consistently low" (5.9%).
  • Individuals in the "consistently low" group had a significantly higher risk of unsuccessful outcomes (hazard ratio [HR] = 43.2; 95% confidence interval [CI]: 26.2-71.5) compared to the "consistently high" group.
  • The "high to low" group (HR = 23.2; 95% CI: 15.7-24.3) also had a higher risk of unsuccessful outcomes compared to the "consistently high" group.
  • The joint latent class mixed model more accurately predicted outcomes than common classification methods (P < 0.001).

Statistics:

  • 72.5% of patients exhibited "consistently high" adherence to treatment.
  • 14.3% of patients showed a "high to low" adherence pattern.
  • 7.3% of patients demonstrated a "low to high" adherence pattern.
  • 5.9% of patients exhibited a "consistently low" adherence pattern.
  • 1787 patients were included in the analysis.

Sources:

  • Characterizing Treatment Adherence Trajectories In the Endtb Multisite Cohort of Drug-resistant Tuberculosis Patients: an Application of Group-based Trajectory Modeling. Clinical Infectious Diseases, 2025.
  • Oxford Univ Press Inc, Journals Dept, 2001 Evans Rd, Cary, NC 27513, USA.
  • Clinical Infectious Diseases - cid.oxfordjournals.org

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