Patient- and Health-System-Related Barriers to Treatment Adherence for Patients with Drug-Resistant Tuberculosis in the Philippines: A Mixed-Methods Study
Table 3
Major barriers, examples, and frequencies of open-ended survey responses to selected questions on major topics of DRTB care.
Patient-related barriers
Health-system-related barriers
Themes
Reply no. (%)
Examples from open-ended survey questions
Themes
Reply no. (%)
Examples from open-ended survey questions
Topic a. Treatment initiation
n =252
n =211
Economic constraints
134 (53%)
Not able to continue work lacking money for transportation
Human resources
120 (57%)
Too many patients
Patient perceptions
115 (46%)
Fear of treatment side effects
Financial support
61 (29%)
Absence of food package
Family-related issues
67 (27%)
Lack of support from family
Limited political support
27 (13%)
Not supportive [sic] LGU
Topic b. Treatment retention
Patient perceptions
59 (28%)
Stigma coming from the…worker
Human resources
73 (41%)
Nurse[s] [have] no time for field visits
Location of patients’ homes
38 (18%)
Centers not capable of TB care
Facility capacity
44 (25%)
[PCC is] afraid of handling DRTB
Lack of family support
26 (12%)
No family support for food
Limited political support
27 (15%)
Insufficient financial support
Topic c. Patient outreach actions
Patient compliance
116 (31%)
Patients refused visit
Human resources
176 (56%)
Because of workload, [we] neglect to contact patients
Contact information
113 (30%)
Patient has no phone at all
Limited financial support
50 (16%)
Vehicle should be provided
Remoteness of patient homes
22 (12%)
Unavailability of transportation
Poor phone coverage
29 (9%)
There is no network coverage
Topic d. Management of nausea and vomiting
Patient perceptions of medication
54 (36%)
Concerned [with] additional medications
Human resources Unavailable drugs
34 (27%) 20 (16%)
No staff to monitor nausea Interrupted medicine supply
Notes: Respondents’ numbers in topic c ( for patient-related barriers, for health-system-related barriers) were more than 272, the total number of participants in the survey, because responses to two different questions regarding topic c were compiled. Abbreviations: ADR: adverse drug reaction; CTP: community treatment partner; DOH: Department of Health; LGU: local government unit; NTP: National Tuberculosis Control Program; PCC: primary care center, TB: tuberculosis.
