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已发表论文
耐药结核病患者药物依从性的现实困境与促进因素：基于患者视角的定性探究
Authors Xia X, Huang F, Wang Y, Lin X , Cheng J, Chen T, Jiang L, Chen Y, Zhang D, Tang J
Received 17 July 2025
Accepted for publication 8 October 2025
Published 16 October 2025 Volume 2025:18 Pages 5351—5364
DOI https://doi.org/10.2147/IDR.S554556
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Hemant Joshi
Xiaoli Xia,1 Fuli Huang,2 Ying Wang,2 Xue Lin,1 Jie Cheng,1 Tingting Chen,1 Liwen Jiang,1 Yanhua Chen,1 Daiying Zhang,3 Jian Tang2,4
1School of Nursing, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 2Department of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 3Department of Operating Room, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 4Department of Antiviral Therapy, the First People’s Hospital of Yuexi County, Liangshan, Sichuan, 616651, People’s Republic of China
Correspondence: Jian Tang, Email tangjian034@swmu.edu.cn Daiying Zhang, Email zhangdaiying202112@163.com
Introduction: Drug-resistant tuberculosis (DR-TB) constitutes a global public health crisis, which endangers patients’ health, poses a significant transmission risk, and imposes a substantial strain on the healthcare system. Medication adherence is essential for enhancing treatment outcomes and mitigating the proliferation of DR-TB.
Purpose: This study aims to explore the real-life dilemmas and facilitators affecting medication adherence in DR-TB patients and provide a reference for improving medication compliance in DR-TB patients.
Patients and Methods: A descriptive qualitative study was conducted. 26 patients with DR-TB who were treated with oral medication regimen in a tertiary hospital in Luzhou City, Sichuan Province from March to May 2025 were selected through purposive sampling method for semi-structured interviews, and thematic analysis was used to analyze the data.
Results: Five themes and fourteen sub-themes affecting medication adherence of DR-TB patients were identified, encompassing: Individual physiological traits (age-related variations in the perception of future time, polypharmacy in patients with comorbidities), intricate psychology and behaviors (misconceptions of medication effects, psychological distress resulting from stigma, misunderstanding of disease conditions, downward social comparison, divergences in medicine administration practices), synergy in social networks (multi-dimensional support of family members, support and communication from health providers), differences in family finances and living situations (significant family financial strain, influence of family roles), and constraints on medical insurance services (disparities in health insurance coverage, intricacy of the reimbursement procedure, constraints on reimbursement amounts and coverage).
Conclusion: Adherence to medication among DR-TB patients is influenced by intricate factors. Health professionals should intervene on the basis of a comprehensive and dynamic assessment of medication adherence to address these influencing factors at various levels, thereby enhancing adherence and therapeutic outcomes.
Keywords: drug-resistant tuberculosis, medication adherence, qualitative research, influencing factors, health ecology model
1School of Nursing, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 2Department of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 3Department of Operating Room, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 4Department of Antiviral Therapy, the First People’s Hospital of Yuexi County, Liangshan, Sichuan, 616651, People’s Republic of China
Correspondence: Jian Tang, Email tangjian034@swmu.edu.cn Daiying Zhang, Email zhangdaiying202112@163.com
Introduction: Drug-resistant tuberculosis (DR-TB) constitutes a global public health crisis, which endangers patients’ health, poses a significant transmission risk, and imposes a substantial strain on the healthcare system. Medication adherence is essential for enhancing treatment outcomes and mitigating the proliferation of DR-TB.
Purpose: This study aims to explore the real-life dilemmas and facilitators affecting medication adherence in DR-TB patients and provide a reference for improving medication compliance in DR-TB patients.
Patients and Methods: A descriptive qualitative study was conducted. 26 patients with DR-TB who were treated with oral medication regimen in a tertiary hospital in Luzhou City, Sichuan Province from March to May 2025 were selected through purposive sampling method for semi-structured interviews, and thematic analysis was used to analyze the data.
Results: Five themes and fourteen sub-themes affecting medication adherence of DR-TB patients were identified, encompassing: Individual physiological traits (age-related variations in the perception of future time, polypharmacy in patients with comorbidities), intricate psychology and behaviors (misconceptions of medication effects, psychological distress resulting from stigma, misunderstanding of disease conditions, downward social comparison, divergences in medicine administration practices), synergy in social networks (multi-dimensional support of family members, support and communication from health providers), differences in family finances and living situations (significant family financial strain, influence of family roles), and constraints on medical insurance services (disparities in health insurance coverage, intricacy of the reimbursement procedure, constraints on reimbursement amounts and coverage).
Conclusion: Adherence to medication among DR-TB patients is influenced by intricate factors. Health professionals should intervene on the basis of a comprehensive and dynamic assessment of medication adherence to address these influencing factors at various levels, thereby enhancing adherence and therapeutic outcomes.
Keywords: drug-resistant tuberculosis, medication adherence, qualitative research, influencing factors, health ecology model