A predictive scoring instrument for tuberculosis lost to follow-up outcome
Por:
Rodrigo, T, Cayla, JA, Casals, M, Garcia-Garcia, JM, Caminero, JA, Ruiz-Manzano, J, Blanquer, R, Vidal, R, Altet, N, Calpe, JL, Penas, A
Publicada:
2 sep 2012
Resumen:
Background: Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to develop and validate a scoring system to predict the probability of lost to follow-up outcome in TB patients as a way to identify patients suitable for directly observed treatments (DOT) and other interventions to improve adherence.
Methods: Two prospective cohorts, were used to develop and validate a logistic regression model. A scoring system was constructed, based on the coefficients of factors associated with a lost to follow-up outcome. The probability of lost to follow-up outcome associated with each score was calculated. Predictions in both cohorts were tested using receiver operating characteristic curves (ROC).
Results: The best model to predict lost to follow-up outcome included the following characteristics: immigration (1 point value), living alone (1 point) or in an institution (2 points), previous anti-TB treatment (2 points), poor patient understanding (2 points), intravenous drugs use (IDU) (4 points) or unknown IDU status (1 point). Scores of 0, 1, 2, 3, 4 and 5 points were associated with a lost to follow-up probability of 2,2% 5,4% 9,9%, 16,4%, 15%, and 28%, respectively. The ROC curve for the validation group demonstrated a good fit (AUC: 0,67 [95% CI; 0,65-0,70]).
Conclusion: This model has a good capacity to predict a lost to follow-up outcome. Its use could help TB Programs to determine which patients are good candidates for DOT and other strategies to improve TB treatment adherence.
Filiaciones:
Rodrigo, T:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Agencia Salud Publ Barcelona, Serv Epidemiol, Unidad Invest TB Barcelona, Barcelona, Spain
Fdn RESPIRA SEPAR, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Barcelona, Spain
Cayla, JA:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Agencia Salud Publ Barcelona, Serv Epidemiol, Unidad Invest TB Barcelona, Barcelona, Spain
Fdn RESPIRA SEPAR, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Barcelona, Spain
Casals, M:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Barcelona, Spain
Univ Barcelona, Dept Salut Publ, Barcelona, Spain
Garcia-Garcia, JM:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Hosp San Agustin, Aviles, Asturias, Spain
Caminero, JA:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Int Union TB & Lung Dis, Paris, France
Ruiz-Manzano, J:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
CIBER Enfermedades Resp CIBERES, Barcelona, Spain
Blanquer, R:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Hosp Univ Dr Peset Valencia, Valencia, Spain
Vidal, R:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Hosp Vall dHebron Barcelona, Barcelona, Spain
CIBER Enfermedades Resp CIBERES, Barcelona, Spain
Altet, N:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Unidad Prevenc & Control TB Barcelona, Barcelona, Spain
Calpe, JL:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Hosp Marina Baixa Alicante, Alicante, Spain
Penas, A:
Soc Espanola Neumol & Cirugia Torac SEPAR, Programa Integrado Invest TB PII TB, Barcelona, Spain
Complejo Hosp Xeral Calde, Lugo, Spain
Gold, Green Published
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