THERAPEUTIC PATIENT EDUCATION: A CORNERSTONE OF ADHERENCE AND EFFECTIVENESS IN TUBERCULOSIS TREATMENT.
DOI:
https://doi.org/10.61841/8mxqcr88Abstract
Tuberculosis is a major cause of morbidity and mortality worldwide, affecting mainly low- and middle-income countries, but persisting in vulnerable populations in high-income countries. The effectiveness of tuberculosis treatments depends on strict adherence, which is often compromised by the length of the protocols, adverse drug effects, and unfavorable psychosocial determinants. Patient therapeutic education is a structured, multidisciplinary strategy aimed at strengthening the knowledge, self-management skills, and autonomy of patients with tuberculosis, whether they have latent tuberculosis infection or active tuberculosis disease. It is complementary, improving treatment adherence and clinical outcomes and helping to strengthen the fight against tuberculosis.
References
Global tuberculosis report 2024. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024
Implementing the end TB strategy: the essentials, 2022 update. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO. Available from: https://www.who.int/publications/i/item/9789240065093
WHO consolidated guidelines on tuberculosis. Module 4: treatment and care. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO. Available from: https://iris.who.int/server/api/core/bitstreams/f663f086-5d97-4355-beea-0635d47f1227/content
Dellal M, Batoui S, Aassem Y, Habbari K. Factors influencing adherence to anti-tuberculosis treatment in Morocco: a cross-sectional study from the Béni Mellal-Khénifra region. Osong Public Health Res Perspect. 2025 Oct;16(5):476–485. doi:10.24171/j.phrp.2025.0153. Epub 2025 Sep 19. PMID: 41025160; PMCID: PMC12611531.
Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, Volmink J. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med. 2007 Jul 24;4(7):e238. doi:10.1371/journal.pmed.0040238. PMID: 17676945; PMCID: PMC1925126.
Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Available from: https://iris.who.int/server/api/core/bitstreams/d68456c8-2a25-419b-83eb-1dc9df1b838f/content
World Health Organization Regional Office for Europe. Therapeutic patient education: continuing education programmes for health care providers in the field of prevention of chronic diseases: report of a WHO working group. Copenhagen: WHO Regional Office for Europe; 1998. Available from: https://iris.who.int/items/38eea932-59cf-4af9-be3c-826d99ad1f94
Tola HH, Shojaeizadeh D, Tol A, Garmaroudi G, Yekaninejad MS, Kebede A, et al. Psychological and educational intervention to improve tuberculosis treatment adherence in Ethiopia based on Health Belief Model: a cluster randomized control trial. PLoS One. 2016 May 11;11(5):e0155147. doi:10.1371/journal.pone.0155147. PMID: 27167378; PMCID: PMC4864292.
Perriot J, Masson M, Peiffer G. Strengthening therapeutic education for tuberculosis patients. Rev Infirm. 2025 Dec;74(316):41–43. doi:10.1016/j.revinf.2025.10.031. Epub 2025 Nov 26. PMID: 41371817.
Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep. 2010 Jul–Aug;125 Suppl 4:34–42. doi:10.1177/00333549101250S407. PMID: 20626191; PMCID: PMC2882973.
Scheen AJ, Bourguignon JP, Guillaume M. Therapeutic education: a solution to reduce therapeutic inertia and noncompliance. Rev Med Liege. 2010 May–Jun;65(5–6):250–255. PMID: 20684402.
Karumbi J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev. 2015 May 29;2015(5):CD003343. doi:10.1002/14651858.CD003343.pub4. PMID: 26022367; PMCID: PMC4460720.
Olowoyo KS, Esan DT, Adeyanju BT, Olawade DB, Oyinloye BE, Olowoyo P. Telemedicine as a tool to prevent multi-drug resistant tuberculosis in poor resource settings: lessons from Nigeria. J Clin Tuberc Other Mycobact Dis. 2024 Feb 24;35:100423. doi:10.1016/j.jctube.2024.100423. PMID: 38435000; PMCID: PMC10907208.
Subbaraman R, de Mondesert L, Musiimenta A, Pai M, Mayer KH, Thomas BE, et al. Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities. BMJ Glob Health. 2018 Oct 11;3(5):e001018. doi:10.1136/bmjgh-2018-001018. PMID: 30364330; PMCID: PMC6195152.
Ridho A, Alfian SD, van Boven JFM, Levita J, Yalcin EA, Le L, et al. Digital health technologies to improve medication adherence and treatment outcomes in patients with tuberculosis: systematic review of randomized controlled trials. J Med Internet Res. 2022 Feb 23;24(2):e33062. doi:10.2196/33062. PMID: 35195534; PMCID: PMC8908199.
Alipanah N, Jarlsberg L, Miller C, Linh NN, Falzon D, Jaramillo E, et al. Adherence interventions and outcomes of tuberculosis treatment: a systematic review and meta-analysis of trials and observational studies. PLoS Med. 2018 Jul 3;15(7):e1002595. doi:10.1371/journal.pmed.1002595. PMID: 29969463; PMCID: PMC6029765.
Story A, Garber E, Aldridge RW, Smith CM, Hall J, Ferenando G, et al. Management and control of tuberculosis in socially complex groups: a research programme including three RCTs. Southampton (UK): NIHR Journals Library; 2020 Oct. PMID: 33119243.
Jadgal KM, Nakhaei-Moghadam T, Alizadeh-Seiouki H, Zareban I, Sharifi-Rad J. Impact of educational intervention on patients’ behavior with smear-positive pulmonary tuberculosis: a study using the Health Belief Model. Mater Sociomed. 2015 Aug;27(4):229–233. doi:10.5455/msm.2015.27.229-233. PMID: 26543411; PMCID: PMC4610657.
Lutge EE, Wiysonge CS, Knight SE, Volmink J. Material incentives and enablers in the management of tuberculosis. Cochrane Database Syst Rev. 2012 Jan 18;(1):CD007952. doi:10.1002/14651858.CD007952.pub2. Update in: Cochrane Database Syst Rev. 2015 Sep 3;(9):CD007952. doi:10.1002/14651858.CD007952.pub3. PMID: 22258976.
Riccardi N, Rodari P, Duranti S, Villa S, Assante LR, Castellotti P, et al. How to improve TB outpatient service in a low-endemic country during the SARS-CoV-2 pandemic. J Prev Med Hyg. 2021 Jun 5;62(1 Suppl 3):E50–E52. doi:10.15167/2421-4248/jpmh2021.62.1S3.2008. PMID: 34622084; PMCID: PMC8452285.
Bao Y, Wang C, Xu H, Lai Y, Yan Y, Ma Y, et al. Effects of an mHealth intervention for pulmonary tuberculosis self-management based on the integrated theory of health behavior change: randomized controlled trial. JMIR Public Health Surveill. 2022 Jul 14;8(7):e34277. doi:10.2196/34277. PMID: 35834302; PMCID: PMC9335179.
Filho FGSDS, Falcão IWS, de Souza TM, Carneiro SR, da Rocha Seruffo MC, et al. Integrated artificial intelligence framework for tuberculosis treatment abandonment prediction: a multi-paradigm approach. J Clin Med. 2025 Dec 6;14(24):8646. doi:10.3390/jcm14248646. PMID: 41464549; PMCID: PMC12733801.
Zhao CY, Song C, Jiang CY, Liu RH, Wei LY, Zeng CM, et al. Large language models in tuberculosis patients’ health consultation and patient education: a comprehensive performance analysis study. J Infect. 2025 Jul;91(1):106527. doi:10.1016/j.jinf.2025.106527. Epub 2025 Jun 2. PMID: 40466746.
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